Basic Information
Provider Information
NPI: 1073999108
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARIAS
FirstName: ROXANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2040 CAMFIELD AVE
Address2:  
City: COMMERCE
State: CA
PostalCode: 900401502
CountryCode: US
TelephoneNumber: 3237258751
FaxNumber:  
Practice Location
Address1: 535 S 2ND AVE
Address2:  
City: COVINA
State: CA
PostalCode: 917233013
CountryCode: US
TelephoneNumber: 6262141484
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/30/2015
LastUpdateDate: 07/30/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WC0400X847492CAY Nursing Service ProvidersRegistered NurseCase Management
163WC1500X847492CAN Nursing Service ProvidersRegistered NurseCommunity Health

No ID Information.


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