Healthcare Provider Details

I. General information

NPI: 1356264329
Provider Name (Legal Business Name): ROXANNE DLUZAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 E PALOMAR ST
CHULA VISTA CA
91913-1800
US

IV. Provider business mailing address

5800 GRANITE PKWY STE 325
PLANO TX
75024-6898
US

V. Phone/Fax

Practice location:
  • Phone: 972-447-9800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number24674
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: