Provider Demographics
NPI:1538046255
Name:ROJAS CRUZ, CAROLINA
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:ROJAS CRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 252ND ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-1975
Mailing Address - Country:US
Mailing Address - Phone:310-956-0009
Mailing Address - Fax:
Practice Address - Street 1:615 N NASH ST STE 306
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-2850
Practice Address - Country:US
Practice Address - Phone:310-535-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA308712225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist