Provider Demographics
NPI:1932249570
Name:ROCA-TUAZON, JO R (MS, LMFT)
Entity Type:Individual
Prefix:MS
First Name:JO
Middle Name:R
Last Name:ROCA-TUAZON
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:MS
Other - First Name:JO
Other - Middle Name:REME
Other - Last Name:ROCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:16843 VALLEY BLVD
Mailing Address - Street 2:E-532
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-6666
Mailing Address - Country:US
Mailing Address - Phone:951-640-3994
Mailing Address - Fax:909-783-6625
Practice Address - Street 1:700 E GILBERT ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-2421
Practice Address - Country:US
Practice Address - Phone:909-382-3501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 43809106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist