Provider Demographics
NPI:1518714286
Name:BARAJAS, ROSARIO MARIA
Entity type:Individual
Prefix:
First Name:ROSARIO
Middle Name:MARIA
Last Name:BARAJAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23521 PASEO DE VALENCIA STE B11
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3145
Mailing Address - Country:US
Mailing Address - Phone:949-422-2093
Mailing Address - Fax:949-446-4446
Practice Address - Street 1:23521 PASEO DE VALENCIA STE B11
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3145
Practice Address - Country:US
Practice Address - Phone:949-422-2093
Practice Address - Fax:949-446-4446
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19094225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist