Provider Demographics
NPI:1760695894
Name:DA ROSA, JOANA MARIA (DC, DABCO)
Entity Type:Individual
Prefix:DR
First Name:JOANA
Middle Name:MARIA
Last Name:DA ROSA
Suffix:
Gender:F
Credentials:DC, DABCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 SWEET WATER DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-1225
Mailing Address - Country:US
Mailing Address - Phone:925-736-5248
Mailing Address - Fax:
Practice Address - Street 1:461 BUSH ST
Practice Address - Street 2:STE. 388
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-3706
Practice Address - Country:US
Practice Address - Phone:415-391-4919
Practice Address - Fax:415-391-4984
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17662111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU31744Medicare UPIN
CADCO176620Medicare ID - Type Unspecified