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General NPI Number Information
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NPI Number | 1720079957
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Entity Type | Individual
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Provider Name | ROXANNA MORTON
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Gender | Female
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Dates
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Enumeration Date | 11/05/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 29525 CANWOOD ST STE 111
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4233
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Country | US
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Telephone | 818-706-8133
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Fax |
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Provider Business Mailing Address
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Address Line | 2831 LADBROOK WAY
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-5068
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Country | US
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Telephone | 805-495-6959
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN525069
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License Number State | CA
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