Provider Demographics
NPI:1275231649
Name:ROXAS, TERESITA G
Entity Type:Individual
Prefix:
First Name:TERESITA
Middle Name:G
Last Name:ROXAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 HOLIDAY WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-5142
Mailing Address - Country:US
Mailing Address - Phone:760-859-6303
Mailing Address - Fax:
Practice Address - Street 1:290 HOLIDAY WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-5142
Practice Address - Country:US
Practice Address - Phone:760-859-6303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA322317163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse