Provider Demographics
NPI:1598451379
Name:LEDESMA, ROSELEE JEANNETTE (PHD)
Entity Type:Individual
Prefix:
First Name:ROSELEE
Middle Name:JEANNETTE
Last Name:LEDESMA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 WALSH ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-3624
Mailing Address - Country:US
Mailing Address - Phone:760-828-6343
Mailing Address - Fax:
Practice Address - Street 1:259 WALSH ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-3624
Practice Address - Country:US
Practice Address - Phone:760-828-6343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program