Provider Demographics
NPI:1669928537
Name:QUEZADA, ROCIO
Entity type:Individual
Prefix:MRS
First Name:ROCIO
Middle Name:
Last Name:QUEZADA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ROCIO
Other - Middle Name:
Other - Last Name:SALAIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9033 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-3839
Mailing Address - Country:US
Mailing Address - Phone:562-942-9625
Mailing Address - Fax:562-943-9695
Practice Address - Street 1:9033 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-3839
Practice Address - Country:US
Practice Address - Phone:562-942-9625
Practice Address - Fax:562-943-9695
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator