Provider Demographics
NPI:1013399070
Name:MINAKAWA, ROSANGELA
Entity Type:Individual
Prefix:MS
First Name:ROSANGELA
Middle Name:
Last Name:MINAKAWA
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 1:4319 COPELAND AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-1235
Mailing Address - Country:US
Mailing Address - Phone:619-408-6630
Mailing Address - Fax:
Practice Address - Street 1:4319 COPELAND AVE
Practice Address - Street 2:APT 3
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-1235
Practice Address - Country:US
Practice Address - Phone:619-408-6630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA789127163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse