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General NPI Number Information
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NPI Number | 1053950287
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Entity Type | Individual
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Provider Name | CAITLIN ROTA
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Gender | Female
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Dates
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Enumeration Date | 01/06/2020
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Last Update Date | 02/26/2021
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Provider Practice Location Address
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Address Line | 432 S PACIFIC COAST HWY
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City | REDONDO BEACH
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State | CA
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Zip | 90277-3735
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Country | US
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Telephone | 310-710-1341
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Fax |
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Provider Business Mailing Address
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Address Line | 7016 KENTWOOD AVE
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City | LOS ANGELES
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State | CA
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Zip | 90045-1220
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Country | US
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Telephone | 310-710-1341
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 95010981
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License Number State | CA
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