Most Relevant Information
Provider Data
| NPI Number: | 1003590910 |
| Provider Name: | DESTINY ROCHESTER |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/12/2023 |
| Last Updated: | 06/12/2023 |
Provider Practice Location
98 S LOS ROBLES AVE
PASADENA
CA
911012433
Practice Location Phone/Fax
| Phone: | 8885763348 |
| Fax: |
Provider Mailing Location
98 S LOS ROBLES AVE
PASADENA
CA
911012433
Provider Mailing Phone/Fax
| Phone: | 8885763348 |
| Fax: |