Healthcare Provider Details

I. General information

NPI: 1104742337
Provider Name (Legal Business Name): JESSICA ROCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BUTLER CT
ROSEVILLE CA
95678-1249
US

IV. Provider business mailing address

501 BUTLER CT
ROSEVILLE CA
95678-1249
US

V. Phone/Fax

Practice location:
  • Phone: 916-803-1655
  • Fax: 916-297-7702
Mailing address:
  • Phone: 916-803-1655
  • Fax: 916-297-7702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number315920300
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: