Provider Demographics
NPI:1023811890
Name:GALVEZ, ROCHELLE AGONCILLO
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:AGONCILLO
Last Name:GALVEZ
Suffix:
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 1:1540 W GLENOAKS BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-3156
Mailing Address - Country:US
Mailing Address - Phone:818-245-6718
Mailing Address - Fax:
Practice Address - Street 1:1540 W GLENOAKS BLVD STE 104
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-3156
Practice Address - Country:US
Practice Address - Phone:818-245-6718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38931235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist