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General NPI Number Information
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NPI Number | 1285287219
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Entity Type | Individual
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Provider Name | GRACIELA ROMERO
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Gender | Female
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 29441 BOVENZI WAY
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City | WINCHESTER
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State | CA
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Zip | 92596-6069
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Country | US
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Telephone | 951-314-4443
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Fax |
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Provider Business Mailing Address
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Address Line | 2008 N GAREY AVE
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City | POMONA
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State | CA
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Zip | 91767-2722
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Country | US
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Telephone | 909-623-6131
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Fax | 909-865-9281
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 110261
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 110261
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License Number State | CA
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