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NPI Code Detail

MEDICARE: KENIA ANDREA MOCINOS VERGARA PT

MEDICARE: KENIA ANDREA MOCINOS VERGARA PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist308562CA

General Provider Information

NPI Number : 1154207421
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENIA ANDREA MOCINOS VERGARA PT
Provider Business Mailing Address
First Line : 10175 GRAMERCY PL
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-2208
Country : US
Telephone Number : 951-403-0022
Fax Number :
Provider Business Practice Location Address
First Line : 9900 INDIANA AVE STE 8
Second Line :
City : RIVERSIDE
State : CA
Zip : 92503-5498
Country : US
Telephone Number : 951-376-1120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2025
Last Update Date : 08/13/2025

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Directions to “ KENIA ANDREA MOCINOS VERGARA PT” Practice Location

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