Provider Demographics
NPI:1922541234
Name:ROSAS, JESSICA (LSW, MSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ROSAS
Suffix:
Gender:F
Credentials:LSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 SINCLAIR ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-2318
Mailing Address - Country:US
Mailing Address - Phone:775-682-1352
Mailing Address - Fax:775-352-8098
Practice Address - Street 1:777 SINCLAIR ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-2318
Practice Address - Country:US
Practice Address - Phone:775-682-1352
Practice Address - Fax:775-352-8098
Is Sole Proprietor?:No
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-9391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical