Provider Demographics
NPI:1558696096
Name:BUSALPA, RODELIA RAFAEL (FNP)
Entity Type:Individual
Prefix:MS
First Name:RODELIA
Middle Name:RAFAEL
Last Name:BUSALPA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 CLEMENT ST # 111-H1
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1563
Mailing Address - Country:US
Mailing Address - Phone:415-221-4810
Mailing Address - Fax:415-750-6656
Practice Address - Street 1:4150 CLEMENT ST # 111-H1
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1563
Practice Address - Country:US
Practice Address - Phone:415-221-4810
Practice Address - Fax:415-750-6656
Is Sole Proprietor?:No
Enumeration Date:2009-10-15
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18970363L00000X
OR200950136NP FNP-PP174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN708344, NP18970OtherCALIFORNIA BOARD OF NURSING
OR200942619RNOtherOREGON STATE BOARD OF NURSING