Individual
JOHN VINCENT GARO ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 HILLMONT AVE, VENTURA, CA 93003-1647
(805) 652-6729
Mailing address
200 HILLMONT AVE, VENTURA, CA 93003-1647
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
95314970
CA
Other
Enumeration date
11/21/2023
Last updated
11/21/2023
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