Provider Demographics
NPI:1437287521
Name:MBONGO, ROSEMARY KWAYE (MSW INTERN)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:KWAYE
Last Name:MBONGO
Suffix:
Gender:F
Credentials:MSW INTERN
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:DJOUMBISSIA
Other - Last Name:KWAYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 THE ALAMEDA
Mailing Address - Street 2:ALLIANCE FOR COMMUNITY CARE
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1136
Mailing Address - Country:US
Mailing Address - Phone:408-261-7777
Mailing Address - Fax:408-254-9960
Practice Address - Street 1:230 NO MORRISON AVE
Practice Address - Street 2:SUB ACUTE RESIDENTIAL TREATMENT SART
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2741
Practice Address - Country:US
Practice Address - Phone:408-938-8516
Practice Address - Fax:408-295-4231
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker