Healthcare Provider Details

I. General information

NPI: 1952820730
Provider Name (Legal Business Name): REBECCA GABRIELA TERRONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2017
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 THE CITY DR S
ORANGE CA
92868-3205
US

IV. Provider business mailing address

OC HEALTHCARE AGENCY 405 W. 5TH STREET
SANTA ANA CA
92701
US

V. Phone/Fax

Practice location:
  • Phone: 714-935-6363
  • Fax:
Mailing address:
  • Phone: 714-834-3101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number109829
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: