Healthcare Provider Details

I. General information

NPI: 1184510588
Provider Name (Legal Business Name): KASSANDRA ROJAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 S EREMLAND DR
COVINA CA
91723-3186
US

IV. Provider business mailing address

7294 EL PRADO WAY
BUENA PARK CA
90620-1729
US

V. Phone/Fax

Practice location:
  • Phone: 626-966-1577
  • Fax:
Mailing address:
  • Phone: 562-409-5361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: