Healthcare Provider Details

I. General information

NPI: 1427995638
Provider Name (Legal Business Name): ROXANNE ANGELA MAGSINO SANTA ANA
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: ROXANNE SANTA ANA

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 UNIVERSITY AVE SE
MINNEAPOLIS MN
55414-3325
US

IV. Provider business mailing address

3333 UNIVERSITY AVE SE
MINNEAPOLIS MN
55414-3325
US

V. Phone/Fax

Practice location:
  • Phone: 612-331-9413
  • Fax:
Mailing address:
  • Phone: 612-331-9413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: