Provider Demographics
NPI:1831816834
Name:ROJAS RIVERO, JEANNETTE MARGARITA (AMFT)
Entity type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:MARGARITA
Last Name:ROJAS RIVERO
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 BROOKHOLLOW DR # 216
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5411
Mailing Address - Country:US
Mailing Address - Phone:949-645-4723
Mailing Address - Fax:
Practice Address - Street 1:1560 BROOKHOLLOW DR # 216
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5411
Practice Address - Country:US
Practice Address - Phone:949-645-4723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA126555106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist