Provider Demographics
NPI:1376374769
Name:NORWOOD, ROSE (ELECTROLOGIST)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:
Last Name:NORWOOD
Suffix:
Gender:F
Credentials:ELECTROLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31380 DAYBREAK CT
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-6905
Mailing Address - Country:US
Mailing Address - Phone:951-851-5686
Mailing Address - Fax:
Practice Address - Street 1:31606 RAILROAD CANYON RD STE 204
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:CA
Practice Address - Zip Code:92587-9456
Practice Address - Country:US
Practice Address - Phone:951-852-5686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9898225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist