Provider Demographics
NPI:1841422326
Name:DEL ROSARIO-SEGGAY, GAY CONCESA
Entity Type:Individual
Prefix:
First Name:GAY CONCESA
Middle Name:
Last Name:DEL ROSARIO-SEGGAY
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 1:1405 DONNER CT
Mailing Address - Street 2:
Mailing Address - City:SUISUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94585-3046
Mailing Address - Country:US
Mailing Address - Phone:347-952-0679
Mailing Address - Fax:
Practice Address - Street 1:13328 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3902
Practice Address - Country:US
Practice Address - Phone:510-235-3720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028885225100000X
CA35794225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist