Provider Demographics
NPI:1598942153
Name:ROCHA, MARIANA (MSW, ASW)
Entity Type:Individual
Prefix:MRS
First Name:MARIANA
Middle Name:
Last Name:ROCHA
Suffix:
Gender:F
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 ALAMEDA DE LAS PULGAS SUITE 200
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-4061
Mailing Address - Country:US
Mailing Address - Phone:650-573-2777
Mailing Address - Fax:
Practice Address - Street 1:222 PAUL SCANNELL DR
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-4061
Practice Address - Country:US
Practice Address - Phone:650-363-4588
Practice Address - Fax:650-216-9164
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW201231041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health