Provider Demographics
NPI:1255638359
Name:LAGRANGE, ROSEMARY HASSEY (CAS I, RAS I)
Entity type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:HASSEY
Last Name:LAGRANGE
Suffix:
Gender:F
Credentials:CAS I, RAS I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 CAMINO DEL RIO SOUTH
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108
Mailing Address - Country:US
Mailing Address - Phone:619-792-6581
Mailing Address - Fax:
Practice Address - Street 1:1400 N JOHNSON AVE
Practice Address - Street 2:SUITE # 101
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-1650
Practice Address - Country:US
Practice Address - Phone:619-442-0277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)