Healthcare Provider Details

I. General information

NPI: 1629946520
Provider Name (Legal Business Name): BEVERLY ROCAS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S FREMONT AVE
ALHAMBRA CA
91803-8800
US

IV. Provider business mailing address

1000 S FREMONT AVE
ALHAMBRA CA
91803-8800
US

V. Phone/Fax

Practice location:
  • Phone: 626-525-6567
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number95130892
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: