Provider Demographics
NPI:1508687328
Name:CAMPOS, ANA ROSA
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:ROSA
Last Name:CAMPOS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:ROSA
Other - Last Name:RUIZ ROCHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-2616
Mailing Address - Country:US
Mailing Address - Phone:831-322-9473
Mailing Address - Fax:
Practice Address - Street 1:1400 EMELINE AVE BLDG K
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-1976
Practice Address - Country:US
Practice Address - Phone:831-454-4170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker