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Individual

ROXANE RONCAROLO DE VRIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2210 MESA DR STE 5, OCEANSIDE, CA 92054-3701
(760) 736-8700
Mailing address
1691 THE ALAMEDA, SAN JOSE, CA 95126-2203
(408) 287-7526

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
95020083
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1497402184
NPI
CA
Enumeration date
03/03/2022
Last updated
02/24/2023
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