Roxanne Marie Hagan
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Campo, CA
NPI 1275775751 · NPPES record last updated Mar 31, 2009
Key facts
- NPI
- 1275775751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 957 Forest Gate Rd
Campo, CA 91906-3101 - Phone
- (619) 401-3541
- NPI assigned
- Mar 31, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Yes |
Addresses
Primary practice location
957 Forest Gate Rd
Campo, CA 91906-3101
Mailing address
957 Forest Gate Rd
Campo, CA 91906-3101
Phone (619) 401-3541
Other providers in Campo, CA
- Charles Johnson Ethelbah
- Robert Filice
- Heidi Michelle Gonzalez
- Nicolas Gonzalez
- Frederick Grubstad II
- Travis Hamblin
- Mason David Han
- Anthony Jacob Hernandez
- Omar Hernandez
- Tina Ann Holley
All providers in Campo, CA · Addiction (Substance Use Disorder) Counselor in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2009. 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.