Provider Demographics
NPI:1417612813
Name:NUNEZ, ROXANNE FLORES (LMFTA)
Entity type:Individual
Prefix:MS
First Name:ROXANNE
Middle Name:FLORES
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:MS
Other - First Name:ROXANNE
Other - Middle Name:FLORES
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PERSONAL
Mailing Address - Street 1:2351 FELIPE CT
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-8850
Mailing Address - Country:US
Mailing Address - Phone:760-562-8381
Mailing Address - Fax:
Practice Address - Street 1:2351 FELIPE CT
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-8850
Practice Address - Country:US
Practice Address - Phone:760-562-8381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA113992101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health