Provider Demographics
NPI:1306223672
Name:ALAS, ROXANA V (MSW)
Entity Type:Individual
Prefix:MISS
First Name:ROXANA
Middle Name:V
Last Name:ALAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36491 YAMAS DR APT 1003
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-9814
Mailing Address - Country:US
Mailing Address - Phone:951-235-2956
Mailing Address - Fax:
Practice Address - Street 1:28936 OLD TOWN FRONT ST STE 102
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2890
Practice Address - Country:US
Practice Address - Phone:951-235-2956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
822021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical