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NPI Code Detail

MEDICARE: MS. ANA MARICELA ROCHA NP

MEDICARE: MS. ANA MARICELA ROCHA NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse Practitioner95007168CA
2363LG0600XGerontology Nurse Practitioner95007168CA

General Provider Information

NPI Number : 1275059131
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANA MARICELA ROCHA NP
Provider Business Mailing Address
First Line : 2121 SANTA MONICA BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-2303
Country : US
Telephone Number : 310-829-8621
Fax Number : 310-829-8914
Provider Business Practice Location Address
First Line : 12414 EXPOSITION BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1016
Country : US
Telephone Number : 310-272-7640
Fax Number : 310-272-7656
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2017
Last Update Date : 02/16/2024

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