Healthcare Provider Details

I. General information

NPI: 1881588911
Provider Name (Legal Business Name): ROXANA PERALTA ESCALANTE B.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18700 DECKER RD
PERRIS CA
92570-7159
US

IV. Provider business mailing address

237 N RIVERSIDE AVE
RIALTO CA
92376-5923
US

V. Phone/Fax

Practice location:
  • Phone: 951-624-6304
  • Fax:
Mailing address:
  • Phone: 877-323-4283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: