Provider Demographics
NPI:1811696842
Name:ROJAS SANTIBANEZ, CAROLINA (LVN)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:ROJAS SANTIBANEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:CAROLINA
Other - Middle Name:
Other - Last Name:ROJAS SANTIBANEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LVN
Mailing Address - Street 1:40335 WINCHESTER RD STE E
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5518
Mailing Address - Country:US
Mailing Address - Phone:619-772-6189
Mailing Address - Fax:
Practice Address - Street 1:22500 TOWN CIR
Practice Address - Street 2:SUITE #2205
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553
Practice Address - Country:US
Practice Address - Phone:619-772-6189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA731062164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse