Provider Demographics
NPI:1528536281
Name:WHITNEY, ROXANNE C
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:C
Last Name:WHITNEY
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 1:2540 COUNTRY HILLS RD APT 280
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-4647
Mailing Address - Country:US
Mailing Address - Phone:714-496-7579
Mailing Address - Fax:
Practice Address - Street 1:2540 COUNTRY HILLS RD APT 280
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-4647
Practice Address - Country:US
Practice Address - Phone:714-496-7579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-10
Last Update Date:2018-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistGroup - Single Specialty