MEDICARE: ROSARIO MARIA BARAJAS

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
1	225700000X	Massage Therapist	19094	CA

General Provider Information

NPI Number	:	1518714286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSARIO MARIA BARAJAS

Provider Business Mailing Address
First Line	:	23521 PASEO DE VALENCIA STE B11
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3145
Country	:	US
Telephone Number	:	949-422-2093
Fax Number	:	949-446-4446

Provider Business Practice Location Address
First Line	:	23521 PASEO DE VALENCIA STE B11
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3145
Country	:	US
Telephone Number	:	949-422-2093
Fax Number	:	949-446-4446

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2024
Last Update Date	:	05/01/2024

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