Individual
LISA ANNETTE ROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.C.P.
Contact information
Practice address
16598 WITHERS WAY, MORENO VALLEY, CA 92555-3343
(951) 870-9007
Mailing address
16598 WITHERS WAY, MORENO VALLEY, CA 92555-3343
(951) 870-9007
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
00016364
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00016364
RESPIRATORY CARE BOARD
CA
Enumeration date
10/01/2007
Last updated
10/01/2007
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