Provider Demographics
NPI:1811019011
Name:ROXAS, CRISTIE RODRIGUEZ (RN, NP-C)
Entity Type:Individual
Prefix:MS
First Name:CRISTIE
Middle Name:RODRIGUEZ
Last Name:ROXAS
Suffix:
Gender:F
Credentials:RN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9871 FIELDTHORN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-4414
Mailing Address - Country:US
Mailing Address - Phone:858-451-2347
Mailing Address - Fax:
Practice Address - Street 1:5202 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-2268
Practice Address - Country:US
Practice Address - Phone:619-229-5415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA520519163WA2000X, 163WC0400X, 163WG0000X, 163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient