Provider Demographics
NPI:1871958702
Name:ROCERO, ROY JR (RPH)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:
Last Name:ROCERO
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9132 CHIANTI CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-3815
Mailing Address - Country:US
Mailing Address - Phone:209-608-2036
Mailing Address - Fax:
Practice Address - Street 1:7860 GERBER RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95828-4302
Practice Address - Country:US
Practice Address - Phone:916-689-8578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-18
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73810183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist