Provider Demographics
NPI:1124277264
Name:FORBES, ROXANA COLETTE (LVN)
Entity type:Individual
Prefix:MS
First Name:ROXANA
Middle Name:COLETTE
Last Name:FORBES
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:ROXANA
Other - Middle Name:COLETTE
Other - Last Name:MCCLORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2925 ILOPANGO DR
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-5422
Mailing Address - Country:US
Mailing Address - Phone:626-333-3735
Mailing Address - Fax:
Practice Address - Street 1:206 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3910
Practice Address - Country:US
Practice Address - Phone:714-895-1985
Practice Address - Fax:714-896-7566
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABN178035164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse