Basic Information
| Provider Information | |||||||||
| NPI: | 1003085598 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAMANIEGO | ||||||||
| FirstName: | ROCIO | ||||||||
| MiddleName: | ERIKA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5005 N PIEDRAS ST | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799205001 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5005 N PIEDRAS ST | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799205001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155692121 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2008 | ||||||||
| LastUpdateDate: | 01/23/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 38742 | TX | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | M-05408 | NM | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041S0200X | 308934 | NM | N | Behavioral Health & Social Service Providers | Social Worker | School |
No ID Information.