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

LicenseStateTypeSpecialty
687248CAMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Wilmington, CA

All providers in Wilmington, CA · Licensed Vocational Nurse in California

Sources for this page

Verify at the official NPI Registry.