Individual
IVAN XAVIER ROJAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1029 N BROADWAY, ESCONDIDO, CA 92026-3043
(760) 489-4126
(760) 489-4129
Mailing address
1029 N BROADWAY, ESCONDIDO, CA 92026-3043
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101YM800X
N/A
CA
Enumeration date
03/16/2022
Last updated
10/10/2023
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