Healthcare Provider Details

I. General information

NPI: 1184375818
Provider Name (Legal Business Name): ROHNDA ROIG LCMT, LCNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROHNDA ROIG LCMT, LCNA

II. Dates (important events)

Enumeration Date: 01/14/2022
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 VANTIS DR UNIT 3049
ALISO VIEJO CA
92656-2515
US

IV. Provider business mailing address

PO BOX 15841
ANAHEIM CA
92803-5841
US

V. Phone/Fax

Practice location:
  • Phone: 949-386-9011
  • Fax:
Mailing address:
  • Phone: 949-386-9011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number84648
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number00841620
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: