Provider Demographics
NPI:1902620792
Name:HORTA-PLANCARTE, AILEEN ROCIO
Entity type:Individual
Prefix:
First Name:AILEEN
Middle Name:ROCIO
Last Name:HORTA-PLANCARTE
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 1:3224 MCHENRY AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-1400
Mailing Address - Country:US
Mailing Address - Phone:209-480-9909
Mailing Address - Fax:
Practice Address - Street 1:3224 MCHENRY AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-1400
Practice Address - Country:US
Practice Address - Phone:209-480-9909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician