Provider Demographics
NPI:1700673167
Name:HUGHES, ROXANNE LYNN (PMHNP)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:LYNN
Last Name:HUGHES
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 CALLE MALAGUENA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-2357
Mailing Address - Country:US
Mailing Address - Phone:949-680-7015
Mailing Address - Fax:
Practice Address - Street 1:512 CALLE MALAGUENA
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-2357
Practice Address - Country:US
Practice Address - Phone:949-680-7015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95034524163WA0400X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)