Provider Demographics
NPI:1619134194
Name:ROSALES, CARMEN G
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:G
Last Name:ROSALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 ENCINAL ST
Mailing Address - Street 2:
Mailing Address - City:SOLEDAD
Mailing Address - State:CA
Mailing Address - Zip Code:93960-3054
Mailing Address - Country:US
Mailing Address - Phone:831-229-4342
Mailing Address - Fax:
Practice Address - Street 1:130 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2632
Practice Address - Country:US
Practice Address - Phone:831-755-8155
Practice Address - Fax:831-422-9411
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator