Provider Demographics
NPI:1467581140
Name:ROSALES, JOSE BENJAMIN (MA)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:BENJAMIN
Last Name:ROSALES
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 KENT CT APT 25
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4123
Mailing Address - Country:US
Mailing Address - Phone:650-207-4288
Mailing Address - Fax:
Practice Address - Street 1:474 VALENCIA ST STE 135
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3415
Practice Address - Country:US
Practice Address - Phone:415-864-0554
Practice Address - Fax:415-701-1868
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist