Provider Demographics
NPI:1609185214
Name:CORTEZ, ROSEANNA (MT)
Entity Type:Individual
Prefix:
First Name:ROSEANNA
Middle Name:
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5788 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-9608
Mailing Address - Country:US
Mailing Address - Phone:559-590-8286
Mailing Address - Fax:
Practice Address - Street 1:5788 LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-9608
Practice Address - Country:US
Practice Address - Phone:559-590-8286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist