Provider Demographics
NPI:1801820352
Name:CHAMBERS, ROSECELLA (CRNA)
Entity Type:Individual
Prefix:
First Name:ROSECELLA
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 CARINGA WAY
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-6302
Mailing Address - Country:US
Mailing Address - Phone:478-960-4892
Mailing Address - Fax:
Practice Address - Street 1:477 N EL CAMINO REAL STE C204
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1332
Practice Address - Country:US
Practice Address - Phone:478-960-4892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000148367500000X
TN258895367500000X
GARN117469367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000851056CMedicaid
GA000851056CMedicaid