Healthcare Provider Details

I. General information

NPI: 1073999108
Provider Name (Legal Business Name): ROXANA ARIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 07/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 S 2ND AVE
COVINA CA
91723-3013
US

IV. Provider business mailing address

2040 CAMFIELD AVE
COMMERCE CA
90040-1502
US

V. Phone/Fax

Practice location:
  • Phone: 626-214-1484
  • Fax:
Mailing address:
  • Phone: 323-725-8751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number847492
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number847492
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: