Provider Demographics
NPI:1467771063
Name:ROCA, TERESA ANNE (PHARM D)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ANNE
Last Name:ROCA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18811 THORN CREST CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91351-5027
Mailing Address - Country:US
Mailing Address - Phone:661-713-1218
Mailing Address - Fax:
Practice Address - Street 1:26900 SIERRA HWY
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2253
Practice Address - Country:US
Practice Address - Phone:661-298-0161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist