Provider Demographics
NPI:1023345998
Name:NARANJO, ROCIO PATRICIA (PA)
Entity type:Individual
Prefix:
First Name:ROCIO
Middle Name:PATRICIA
Last Name:NARANJO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ROCIO
Other - Middle Name:PATRICIA
Other - Last Name:REAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:7471 N FRESNO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2457
Mailing Address - Country:US
Mailing Address - Phone:559-436-4500
Mailing Address - Fax:559-436-0500
Practice Address - Street 1:7471 N FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2457
Practice Address - Country:US
Practice Address - Phone:559-436-4500
Practice Address - Fax:559-436-0500
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20663363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0043790Medicaid
CAZZZ21572ZOtherMEDICARE GROUP PTAN
CAZZZ21572ZMedicare PIN