Provider Demographics
NPI:1831942614
Name:HINOJOSA ROCHA, ANGEL SALVADOR
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:SALVADOR
Last Name:HINOJOSA ROCHA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 S RITA WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-3313
Mailing Address - Country:US
Mailing Address - Phone:760-569-3909
Mailing Address - Fax:760-569-3909
Practice Address - Street 1:1106 S RITA WAY
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-3313
Practice Address - Country:US
Practice Address - Phone:760-569-3909
Practice Address - Fax:760-569-3909
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician