Individual provider · NPI-1

Roxanna-Elitisia Alizadeh-Azardoust

Licensed Vocational Nurse · San Jose, CA

NPI number1104420736
StatusActive
Last updated in NPPESApr 5, 2023

Details

NPI
1104420736
Entity type
Individual (NPI-1)
Name
Roxanna-Elitisia Alizadeh-Azardoust
Sex
Female
Sole proprietor
No
Enumeration date
Nov 24, 2020
Certification date
Apr 5, 2023
Last updated
Apr 5, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
164X00000X Licensed Vocational Nurse718329CAYes
101YM0800X Counselor, Mental Health––

Other names

  • Roxanna Azardoust (Other Name)

Practice location

160 E Virginia St Ste 100
San Jose, CA 95112-5865

Phone 408-938-2113 · Fax 408-579-6143

Mailing address

160 E Virginia St Ste 100
San Jose, CA 95112-5865

Phone 408-938-2113 · Fax 408-579-6143

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