Provider Demographics
NPI:1629622063
Name:ROSE WOO PSYCHOLOGISTS INC
Entity Type:Organization
Organization Name:ROSE WOO PSYCHOLOGISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:WOO
Authorized Official - Last Name:DALE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-568-3858
Mailing Address - Street 1:16 S OAKLAND AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2042
Mailing Address - Country:US
Mailing Address - Phone:626-568-3858
Mailing Address - Fax:
Practice Address - Street 1:16 S OAKLAND AVE STE 214
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2042
Practice Address - Country:US
Practice Address - Phone:626-568-3858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU6023583OtherDMV - CALIFORNIA