Provider Demographics
NPI:1215403126
Name:ROJAS TENA, AZUCENA (LVN)
Entity Type:Individual
Prefix:
First Name:AZUCENA
Middle Name:
Last Name:ROJAS TENA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:AZUCENA
Other - Middle Name:
Other - Last Name:ROJAS DE MENDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5240 OLD REDWOOD HWY APT 5
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-7836
Mailing Address - Country:US
Mailing Address - Phone:707-236-5034
Mailing Address - Fax:
Practice Address - Street 1:5240 OLD REDWOOD HWY APT 5
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-7836
Practice Address - Country:US
Practice Address - Phone:707-236-5034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN692387164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse