Provider Demographics
NPI:1588473748
Name:TRONCOSO, ROXZANN (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:ROXZANN
Middle Name:
Last Name:TRONCOSO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 S STATE COLLEGE BLVD UNIT 350
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-1613
Mailing Address - Country:US
Mailing Address - Phone:909-764-9488
Mailing Address - Fax:
Practice Address - Street 1:115 S STATE COLLEGE BLVD UNIT 350
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-1613
Practice Address - Country:US
Practice Address - Phone:909-764-9488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-02
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95383057163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health