Individual provider Active NPI

Benji Preciado Rocha, DC

  • Chiropractor
  • Fullerton, CA
National Provider Identifier
1801486121
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC34863 Issued in CA
Practice address
501 N Cornell Ave
Fullerton, CA 92831-2744
Phone
(714) 883-3862
NPI assigned
Jan 20, 2021
Last updated
Jul 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC34863 CA Primary

Addresses

Primary practice location

501 N Cornell Ave
Fullerton, CA 92831-2744

Mailing address

501 N Cornell Ave
Fullerton, CA 92831-2744
Phone (714) 883-3862

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@bodydetox.la

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250724004338 CA Practitioner - Chiropractic 7517474505 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC34863CAMDChiropractor
34863CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Preciado Rocha Chiropractic Corporation Chiropractor CurrentSince Jun 30, 2025 Accepting new patients
Tsu Chiropractic Corporation Chiropractor CurrentSince Jan 1, 2023 Accepting new patients
Twins Physical Medicine Corp PastSince Sep 23, 2024 Accepting new patients
Daniel P Sullivan D C a Chiropractic Corp Chiropractor PastSince Jan 1, 2023 Accepting new patients
Twins Wellness Chiropractor PastSince Jan 1, 2021 Accepting new patients

Locations

501 N Cornell Ave
Fullerton, CA 92831
Phone (714) 525-3350

811 S Glendora Ave
West Covina, CA 91790
Phone (626) 960-5096

Interoperability endpoints

  • Direct secure messaging: info@bodydetox.la

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1801486121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N CORNELL AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928312744",
            "telephone_number": "714-883-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N CORNELL AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928312744",
            "telephone_number": "714-883-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRECIADO ROCHA",
        "first_name": "BENJI",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-20",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC34863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@bodydetox.la",
            "affiliation": "N",
            "address_1": "811 S Glendora Ave",
            "city": "West Covina",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917904202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.