Provider Demographics
NPI:1477888675
Name:REGINALDO-ROXAS, RITA (RN)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:REGINALDO-ROXAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-8710
Mailing Address - Country:US
Mailing Address - Phone:510-784-0314
Mailing Address - Fax:510-732-9103
Practice Address - Street 1:1644 CHENEY LN
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4331
Practice Address - Country:US
Practice Address - Phone:510-861-2635
Practice Address - Fax:510-732-9103
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530934163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse