Healthcare Provider Details

I. General information

NPI: 1982240412
Provider Name (Legal Business Name): CHRISTEN LEANNE ROCCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2019
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 SENTER RD
SAN JOSE CA
95111-1121
US

IV. Provider business mailing address

2650 SENTER RD
SAN JOSE CA
95111-1121
US

V. Phone/Fax

Practice location:
  • Phone: 669-250-9151
  • Fax:
Mailing address:
  • Phone: 669-250-9151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number230146993
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: