Provider Demographics
NPI:1093306060
Name:LAQUINON, MELINDA ROCA
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ROCA
Last Name:LAQUINON
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 1:2720 E WALNUT AVE UNIT 30
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-7383
Mailing Address - Country:US
Mailing Address - Phone:714-417-7545
Mailing Address - Fax:
Practice Address - Street 1:2720 E WALNUT AVE UNIT 30
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-7383
Practice Address - Country:US
Practice Address - Phone:714-417-7545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA792279163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse