Provider Demographics
NPI:1659262368
Name:LYTER, ROXANNE LEE
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:LEE
Last Name:LYTER
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 1:601 N DIANTHUS ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5937
Mailing Address - Country:US
Mailing Address - Phone:310-947-1461
Mailing Address - Fax:
Practice Address - Street 1:601 N DIANTHUS ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5937
Practice Address - Country:US
Practice Address - Phone:310-947-1461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95068314163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse