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General NPI Number Information
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NPI Number | 1467369637
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Entity Type | Organization
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Legal Business Name | ROCA HEALTHCARE LICENSED CLINICAL SOCIAL WORKER GROUP, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 2850 MIRA VISTA CT
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City | CORONA
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State | CA
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Zip | 92881-3641
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Country | US
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Telephone | 951-266-6879
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Fax |
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Provider Business Mailing Address
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Address Line | 160 W FOOTHILL PKWY STE 105 PMB 214
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City | CORONA
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State | CA
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Zip | 92882-8545
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Country | US
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Telephone | 951-266-6879
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. MYRIAM CUBILLO
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Credential | LCSW
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Telephone | 951-266-6879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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