Provider Demographics
NPI:1952057630
Name:TERRY, ROCIO MARTINEZ-SANCHEZ
Entity Type:Individual
Prefix:
First Name:ROCIO
Middle Name:MARTINEZ-SANCHEZ
Last Name:TERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROCIO
Other - Middle Name:SANCHEZ
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4102 LAKE CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-7871
Mailing Address - Country:US
Mailing Address - Phone:619-792-3989
Mailing Address - Fax:
Practice Address - Street 1:4102 LAKE CIRCLE DR
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-7871
Practice Address - Country:US
Practice Address - Phone:619-792-3989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1046021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical