Provider Demographics
NPI:1003030784
Name:RODRIGUEZ ROCHE, JOSE A (PSYCHOLOGY)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:RODRIGUEZ ROCHE
Suffix:
Gender:M
Credentials:PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MSC-111, P.O. BOX 6004
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766
Mailing Address - Country:US
Mailing Address - Phone:787-635-2818
Mailing Address - Fax:787-847-3057
Practice Address - Street 1:16 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766-3029
Practice Address - Country:US
Practice Address - Phone:787-847-4270
Practice Address - Fax:787-847-3057
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR561103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical