Provider Demographics
NPI:1386184414
Name:ROCK, DANA (CP)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:
Last Name:ROCK
Suffix:
Gender:F
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 EUCLID ST
Mailing Address - Street 2:APT 5
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4282
Mailing Address - Country:US
Mailing Address - Phone:267-251-8285
Mailing Address - Fax:
Practice Address - Street 1:1022 EUCLID ST
Practice Address - Street 2:APT 5
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4282
Practice Address - Country:US
Practice Address - Phone:267-251-8285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACP0041681744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management