Healthcare Provider Details

I. General information

NPI: 1124566724
Provider Name (Legal Business Name): ROGGIELYZ YOSORES PADILLA NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3655 LOMITA BLVD STE 421
TORRANCE CA
90505-1934
US

IV. Provider business mailing address

3655 LOMITA BLVD STE 421
TORRANCE CA
90505-1934
US

V. Phone/Fax

Practice location:
  • Phone: 310-540-5464
  • Fax: 310-540-4761
Mailing address:
  • Phone: 310-540-5464
  • Fax: 310-540-4761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95005940
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: