Healthcare Provider Details

I. General information

NPI: 1215857602
Provider Name (Legal Business Name): ARISTELA ROBERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 S GRAND AVE
LOS ANGELES CA
90007-3303
US

IV. Provider business mailing address

2802 S GRAND AVE
LOS ANGELES CA
90007-3303
US

V. Phone/Fax

Practice location:
  • Phone: 323-743-8090
  • Fax:
Mailing address:
  • Phone: 323-743-8090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: