Healthcare Provider Details

I. General information

NPI: 1467369637
Provider Name (Legal Business Name): ROCA HEALTHCARE LICENSED CLINICAL SOCIAL WORKER GROUP, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 MIRA VISTA CT
CORONA CA
92881-3641
US

IV. Provider business mailing address

160 W FOOTHILL PKWY STE 105 PMB 214
CORONA CA
92882-8545
US

V. Phone/Fax

Practice location:
  • Phone: 951-266-6879
  • Fax:
Mailing address:
  • Phone: 951-266-6879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. MYRIAM CUBILLO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LCSW
Phone: 951-266-6879