Provider Demographics
NPI:1760824213
Name:TAPIA, ROSLIA
Entity Type:Individual
Prefix:
First Name:ROSLIA
Middle Name:
Last Name:TAPIA
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 1:1949 S MANCHESTER AVE SPC 82
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802-3823
Mailing Address - Country:US
Mailing Address - Phone:714-333-7188
Mailing Address - Fax:
Practice Address - Street 1:1949 S MANCHESTER AVE SPC 82
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-3823
Practice Address - Country:US
Practice Address - Phone:714-333-7188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220028164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse