Basic Information
| Provider Information | |||||||||
| NPI: | 1851903694 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLORES ROJAS | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | ANDREA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 115 | ||||||||
| Address2: | |||||||||
| City: | TUSTIN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927810115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142776516 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1206 E 17TH ST | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927012641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7143522911 | ||||||||
| FaxNumber: | 7143522903 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2020 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 95486 | CA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.