Provider Demographics
NPI:1154606127
Name:LACUESTA GALEON, ROCHELLE JOY (NP)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:JOY
Last Name:LACUESTA GALEON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ROCHELLE
Other - Middle Name:JOY
Other - Last Name:LACUESTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:6811 EMERSON DR
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-1103
Mailing Address - Country:US
Mailing Address - Phone:714-292-9348
Mailing Address - Fax:
Practice Address - Street 1:3565 DEL AMO BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1637
Practice Address - Country:US
Practice Address - Phone:310-214-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20800363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health