Provider Demographics
NPI:1891281796
Name:OROZCO, AIMEE
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:OROZCO
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 1:924 EMERALD BAY RD STE A2
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150-6434
Mailing Address - Country:US
Mailing Address - Phone:530-544-2111
Mailing Address - Fax:530-544-3167
Practice Address - Street 1:924 EMERALD BAY RD STE A2
Practice Address - Street 2:
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-6434
Practice Address - Country:US
Practice Address - Phone:530-544-2111
Practice Address - Fax:530-544-3167
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program