Provider Demographics
NPI:1780915850
Name:PARSONS, ROSE ELLEN (MMS, PA-C)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:ELLEN
Last Name:PARSONS
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 BREWSTER AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1558
Mailing Address - Country:US
Mailing Address - Phone:650-366-4585
Mailing Address - Fax:650-366-3896
Practice Address - Street 1:801 BREWSTER AVE STE 240
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1558
Practice Address - Country:US
Practice Address - Phone:650-366-4585
Practice Address - Fax:650-366-3896
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20722363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant