Roxana Vianney Camacho
Individual provider Active NPI Licensed Vocational Nurse · Wilmington, CA
NPI 1104485846 · NPPES record last updated Jun 6, 2019
Key facts
- NPI
- 1104485846
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Vocational Nurse 164X00000X
- License
- 687248 (CA)
- Practice address
- 117 E Harry Bridges Blvd
Wilmington, CA 90744-5825 - Phone
- (310) 549-8383
- NPI assigned
- Jun 6, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 687248 | CA | MD | Licensed Vocational Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 687248 | CA | Yes |
Addresses
Primary practice location
117 E Harry Bridges Blvd
Wilmington, CA 90744-5825
Mailing address
117 E Harry Bridges Blvd
Wilmington, CA 90744-5825
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- Vanilla P. Brooks
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All providers in Wilmington, CA · Licensed Vocational Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.