Provider Demographics
NPI:1710561725
Name:ROCHA, GABRIELA GUADALUPE
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:GUADALUPE
Last Name:ROCHA
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 1:2770 S MARYLAND PKWY STE 205B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-1565
Mailing Address - Country:US
Mailing Address - Phone:725-206-5714
Mailing Address - Fax:
Practice Address - Street 1:1901 N JONES BLVD APT 1026K
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-3772
Practice Address - Country:US
Practice Address - Phone:702-690-8834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant