Individual
THEATRINA ROSE ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
550 S VERMONT AVE, LOS ANGELES, CA 90020-1912
(213) 738-2382
Mailing address
550 S VERMONT AVE, LOS ANGELES, CA 90020-1912
(213) 738-2382
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
691036
CA
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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