Provider Demographics
NPI:1154322311
Name:NG, ROSALIND S (NP)
Entity Type:Individual
Prefix:
First Name:ROSALIND
Middle Name:S
Last Name:NG
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 1:5017 GOLDEN NUGGET WAY
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-4766
Mailing Address - Country:US
Mailing Address - Phone:805-328-4168
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY DR
Practice Address - Street 2:CAL STATE UNIVERSITY CHANNEL ISLANDS STUDENT HEALTH
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-8599
Practice Address - Country:US
Practice Address - Phone:805-437-8828
Practice Address - Fax:805-437-8829
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA15196363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWNP15196HMedicare PIN
CAWNP15196FMedicare PIN
CAWNP15196JMedicare PIN
CAWNP15196GMedicare PIN
Q43417Medicare UPIN
CAWNP15196IMedicare PIN