Provider Demographics
NPI:1700667797
Name:ROCES, JOAQUIN
Entity Type:Individual
Prefix:
First Name:JOAQUIN
Middle Name:
Last Name:ROCES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 MILL ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1696
Mailing Address - Country:US
Mailing Address - Phone:775-501-8655
Mailing Address - Fax:775-499-5206
Practice Address - Street 1:855 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1696
Practice Address - Country:US
Practice Address - Phone:775-501-8655
Practice Address - Fax:775-499-5206
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician