Provider Demographics
NPI:1225105737
Name:DE LA ROSA, JESSICA JOSELYN (BSW)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:JOSELYN
Last Name:DE LA ROSA
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:132A EATONCREST DR
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1264
Mailing Address - Country:US
Mailing Address - Phone:423-504-6300
Mailing Address - Fax:732-747-7590
Practice Address - Street 1:145 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1717
Practice Address - Country:US
Practice Address - Phone:732-747-9660
Practice Address - Fax:732-747-7590
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker