Provider Demographics
NPI:1659112357
Name:LAROZA-ALLEN, GIENA ROSALIE
Entity type:Individual
Prefix:
First Name:GIENA
Middle Name:ROSALIE
Last Name:LAROZA-ALLEN
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 1:5039 LOTUS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-1307
Mailing Address - Country:US
Mailing Address - Phone:253-370-1118
Mailing Address - Fax:
Practice Address - Street 1:BETTY IRENE MOORE SCHOOL OF NURSING
Practice Address - Street 2:2570 48TH STREET
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-734-2145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95095325163W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No163W00000XNursing Service ProvidersRegistered Nurse