MRS. ROCIO MORA BAENA


Address: 1108 N Angeleno Ave, Azusa, CA 91702-1913
Phone: 6262241287

MRS. ROCIO MORA BAENA (NPI# 1700125572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700125572
Entity Type Individual
Full Name MRS. ROCIO MORA BAENA
Credential R. EEG., CNIM
Practice Address 1108 N Angeleno Ave
Azusa
CA 91702-1913
Mailing Address 1108 N Angeleno Ave
Po Box 911
Azusa
CA 91702-1913
Practice Telephone 6262241287
Mailing Telephone 6262241287
Enumeration Date 2013-02-13
Last Update Date 2013-02-13
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 246ZE0600X Specialist/Technologist, Other
Specialization: Electroneurodiagnostic
349 AND 2565 CA Technologists, Technicians & Other Technical Service Providers

Office Location

Street Address 1108 N ANGELENO AVE
City AZUSA
State CA
Zip Code 91702-1913

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1023489846 Crystal Horton Case Manager/Care Coordinator 23701 E Fork Road, Azusa, CA 91702 2015-10-20
1528438272 Seann Mckay Case Manager/Care Coordinator 23701 E Folk Rd, Azusa, CA 91702 2015-10-06
1437528833 William Clabaugh Case Manager/Care Coordinator 830 S. Azusa Ave., 45, Azusa, CA 91702 2015-09-16
1467850693 Juana Gaeta Speech-Language Pathologist 1016 E Ghent St, Azusa, CA 91702 2014-12-22
1649674508 Colleen Anne Montz Nurse Practitioner 901 E. Alosta Ave., Student Health Center, Azusa, CA 91702 2014-10-21
1285061390 Patrick Ryan Bergeron Physical Therapist 900 W Sierra Madre Avenue, #33, Azusa, CA 91702 2013-10-03
1760768972 Ashley L Wickliffe Student in an Organized Health Care Education/Training Program 901 East Alosta Avenue, Azusa, CA 91702 2011-11-01
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Taxonomy Information

Taxonomy Code 246ZE0600X
Grouping Technologists, Technicians & Other Technical Service Providers
Classification Specialist/Technologist, Other
Specialization Electroneurodiagnostic

Taxonomy Definition

Definition to come...

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Competitor

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City AZUSA
Zip Code 91702

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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