Healthcare Provider Details

I. General information

NPI: 1770408874
Provider Name (Legal Business Name): ROSE CERVANTES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11541 ROSECRANS AVE
NORWALK CA
90650-3898
US

IV. Provider business mailing address

11541 ROSECRANS AVE
NORWALK CA
90650-3898
US

V. Phone/Fax

Practice location:
  • Phone: 562-923-9414
  • Fax: 562-923-9451
Mailing address:
  • Phone: 562-923-9414
  • Fax: 562-923-9451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: