Healthcare Provider Details

I. General information

NPI: 1023925765
Provider Name (Legal Business Name): ROXANA CRUZ
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 EL CAJON BLVD
EL CAJON CA
92020-5714
US

IV. Provider business mailing address

1508 GRANITE HILLS DR UNIT F
EL CAJON CA
92019-3308
US

V. Phone/Fax

Practice location:
  • Phone: 619-205-4585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: