Provider Demographics
NPI:1609149434
Name:ROSARIO, PAMELA GABRIEL (FNP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:GABRIEL
Last Name:ROSARIO
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 1:44274 GEORGE CUSHMAN CT. STE. 210
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592
Mailing Address - Country:US
Mailing Address - Phone:951-302-4603
Mailing Address - Fax:951-302-4605
Practice Address - Street 1:44274 GEORGE CUSHMAN CT. STE. 210
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592
Practice Address - Country:US
Practice Address - Phone:951-302-4603
Practice Address - Fax:951-302-4605
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA571234163W00000X
CA21617363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse