Provider Demographics
NPI:1730483793
Name:CISNEROS-ROCHA, OSCAR
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:
Last Name:CISNEROS-ROCHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1559
Mailing Address - Country:US
Mailing Address - Phone:661-635-3050
Mailing Address - Fax:661-869-1503
Practice Address - Street 1:1400 S UNION AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-4179
Practice Address - Country:US
Practice Address - Phone:661-397-8775
Practice Address - Fax:661-397-8286
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator