Provider Demographics
NPI:1619175064
Name:VANDO, ROSEMARY FREITAS (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:FREITAS
Last Name:VANDO
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 1:2621 CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5920
Mailing Address - Country:US
Mailing Address - Phone:916-443-1397
Mailing Address - Fax:916-443-1398
Practice Address - Street 1:2621 CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5920
Practice Address - Country:US
Practice Address - Phone:916-443-1397
Practice Address - Fax:916-443-1398
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8372103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist