Provider Demographics
NPI:1639558224
Name:PALAGANAS, ROXANNE FELIPE
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:FELIPE
Last Name:PALAGANAS
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 1:4800 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-1299
Mailing Address - Country:US
Mailing Address - Phone:951-222-8151
Mailing Address - Fax:
Practice Address - Street 1:4800 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-1299
Practice Address - Country:US
Practice Address - Phone:951-222-8151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA760280163W00000X, 163WC1400X
CA95002202207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1400XNursing Service ProvidersRegistered NurseCollege Health