Provider Demographics
NPI:1073765913
Name:ROSALES, ROSSANA (NP)
Entity Type:Individual
Prefix:
First Name:ROSSANA
Middle Name:
Last Name:ROSALES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5516 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-2750
Mailing Address - Country:US
Mailing Address - Phone:562-695-1507
Mailing Address - Fax:
Practice Address - Street 1:1240 N MISSION RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1019
Practice Address - Country:US
Practice Address - Phone:323-226-3106
Practice Address - Fax:323-226-2829
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16366363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology