Provider Demographics
NPI:1679244537
Name:GARCIA, ROCIO DEL SOCORRO
Entity Type:Individual
Prefix:
First Name:ROCIO DEL
Middle Name:SOCORRO
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 BEACHSIDE LN UNIT 120
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-6592
Mailing Address - Country:US
Mailing Address - Phone:619-902-9060
Mailing Address - Fax:
Practice Address - Street 1:5200 BEACHSIDE LN UNIT 120
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-6592
Practice Address - Country:US
Practice Address - Phone:619-902-9060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAANDRARG421BTOtherDRIVERS LICENSE