Provider Demographics
NPI:1740621028
Name:ROJAS, KATHLEEN JERENE
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:JERENE
Last Name:ROJAS
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:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:OJO CALIENTE
Mailing Address - State:NM
Mailing Address - Zip Code:87549-0028
Mailing Address - Country:US
Mailing Address - Phone:415-571-5862
Mailing Address - Fax:
Practice Address - Street 1:35197 US HIGHWAY 285
Practice Address - Street 2:
Practice Address - City:OJO CALIENTE
Practice Address - State:NM
Practice Address - Zip Code:87549-0028
Practice Address - Country:US
Practice Address - Phone:415-571-5862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No171M00000XOther Service ProvidersCase Manager/Care Coordinator