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General NPI Number Information
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NPI Number | 1316863913
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Entity Type | Individual
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Provider Name | ROI GERRICK LAMCO RELOSA
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Gender | Male
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Dates
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Enumeration Date | 06/26/2026
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Last Update Date | 06/26/2026
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Provider Practice Location Address
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Address Line | 1509 WILSON TER
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City | GLENDALE
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State | CA
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Zip | 91206-4007
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Country | US
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Telephone | 551-236-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 1485 MARIGOLD DR
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City | PERRIS
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State | CA
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Zip | 92571-7560
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95039253
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License Number State | CA
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