Provider Demographics
NPI:1801155304
Name:ROSEBAUGH, ERIKA (RDHAP)
Entity type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:
Last Name:ROSEBAUGH
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7731 FOPPIANO WAY
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-7701
Mailing Address - Country:US
Mailing Address - Phone:707-836-3111
Mailing Address - Fax:
Practice Address - Street 1:7731 FOPPIANO WAY
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CA
Practice Address - Zip Code:95492-6692
Practice Address - Country:US
Practice Address - Phone:707-836-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA377124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist