Provider Demographics
NPI:1942948880
Name:ROMERO, ADELA VIVIANA I
Entity Type:Individual
Prefix:
First Name:ADELA
Middle Name:VIVIANA
Last Name:ROMERO
Suffix:I
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 1:21652 CONSEJOS
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-1125
Mailing Address - Country:US
Mailing Address - Phone:949-774-9703
Mailing Address - Fax:
Practice Address - Street 1:600 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:LADERA RANCH
Practice Address - State:CA
Practice Address - Zip Code:92694-2106
Practice Address - Country:US
Practice Address - Phone:949-661-6753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician