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General NPI Number Information
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NPI Number | 1942438791
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Entity Type | Individual
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Provider Name | ROXANNE E. ROCKWELL PHD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 4510 EXECUTIVE DR STE 315
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City | SAN DIEGO
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State | CA
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Zip | 92121-3029
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Country | US
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Telephone | 858-534-8065
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Fax |
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Provider Business Mailing Address
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Address Line | 635 CANOPY DR
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City | SAN MARCOS
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State | CA
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Zip | 92069-6537
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Country | US
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Telephone | 858-212-1831
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 28078
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License Number State | CA
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