Healthcare Provider Details

I. General information

NPI: 1093363863
Provider Name (Legal Business Name): ROCIO TERRONES MPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17053 FOOTHILL BLVD BLDG B
FONTANA CA
92335-3574
US

IV. Provider business mailing address

PO BOX 919
FULLERTON CA
92836-0919
US

V. Phone/Fax

Practice location:
  • Phone: 909-347-1301
  • Fax:
Mailing address:
  • Phone: 714-680-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: