Individual
ROXANNE PAULETTE PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6154 MISSION GORGE RD, 120, SAN DIEGO, CA 92120-3493
(619) 285-1718
(619) 285-3803
Mailing address
2012 ROSECRANS ST, SAN DIEGO, CA 92106-1931
(619) 223-3485
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
261QR0405X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37AL
—
CA
Enumeration date
03/14/2008
Last updated
03/14/2008
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