Healthcare Provider Details

I. General information

NPI: 1689797961
Provider Name (Legal Business Name): RUBEN HENRY ROJAS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 N ANDERSON RD
EXETER CA
93221-9674
US

IV. Provider business mailing address

PO BOX 917
TULARE CA
93275-0917
US

V. Phone/Fax

Practice location:
  • Phone: 559-594-4855
  • Fax:
Mailing address:
  • Phone: 559-901-0840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS12822
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: