Provider Demographics
NPI:1528320025
Name:DELROSALCERVANTES, ROSA DINA
Entity type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:DINA
Last Name:DELROSALCERVANTES
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 1:2037 VANCOUVER AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-5907
Mailing Address - Country:US
Mailing Address - Phone:562-866-8956
Mailing Address - Fax:
Practice Address - Street 1:17800 WOODRUFF AVE STE F
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-7080
Practice Address - Country:US
Practice Address - Phone:156-286-6895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health