Provider Demographics
NPI:1649461195
Name:SEGOVIA-BAIN, ROSSANA (RN, NP-C)
Entity type:Individual
Prefix:
First Name:ROSSANA
Middle Name:
Last Name:SEGOVIA-BAIN
Suffix:
Gender:F
Credentials:RN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2915 SANTOS LN APT 2222
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-7586
Mailing Address - Country:US
Mailing Address - Phone:925-952-4580
Mailing Address - Fax:
Practice Address - Street 1:1600 DIVISADERO ST # 1661
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3010
Practice Address - Country:US
Practice Address - Phone:415-885-7665
Practice Address - Fax:415-771-4472
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP 13598363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health