Provider Demographics
NPI:1922649870
Name:BANIWAS, ROSALINDA TINDAAN
Entity Type:Individual
Prefix:
First Name:ROSALINDA
Middle Name:TINDAAN
Last Name:BANIWAS
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 1:3832 PERIDOT CT
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-7287
Mailing Address - Country:US
Mailing Address - Phone:805-889-8807
Mailing Address - Fax:951-943-5580
Practice Address - Street 1:3832 PERIDOT CT
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-7287
Practice Address - Country:US
Practice Address - Phone:805-889-8807
Practice Address - Fax:951-943-5580
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider