Provider Demographics
NPI:1316695406
Name:ROJO, DENISE GRACIELA (RX TECH)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:GRACIELA
Last Name:ROJO
Suffix:
Gender:F
Credentials:RX TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3451 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-2721
Mailing Address - Country:US
Mailing Address - Phone:951-534-3846
Mailing Address - Fax:
Practice Address - Street 1:6150 VAN BUREN BLVD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-8014
Practice Address - Country:US
Practice Address - Phone:951-688-5155
Practice Address - Fax:951-688-4421
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA155652183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician