Healthcare Provider Details

I. General information

NPI: 1033929617
Provider Name (Legal Business Name): ROXANNA YVETH BORJON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROXANNA YVETH VERDUGO

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

867 N FAIR OAKS AVE
PASADENA CA
91103-3050
US

IV. Provider business mailing address

867 N FAIR OAKS AVE
PASADENA CA
91103-3050
US

V. Phone/Fax

Practice location:
  • Phone: 626-319-7430
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: