Provider Demographics
NPI:1285028019
Name:TIBAY, ROSEMARIE (RN)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:TIBAY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4633
Mailing Address - Country:US
Mailing Address - Phone:925-313-6098
Mailing Address - Fax:925-313-6599
Practice Address - Street 1:13601 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3818
Practice Address - Country:US
Practice Address - Phone:510-231-9469
Practice Address - Fax:510-374-1090
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA439027163WP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatal