Provider Demographics
NPI:1821211608
Name:MULKEY, ROSEL MARIE (PHD, LAC)
Entity type:Individual
Prefix:MS
First Name:ROSEL
Middle Name:MARIE
Last Name:MULKEY
Suffix:
Gender:F
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:920 NORTHGATE DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-3429
Mailing Address - Country:US
Mailing Address - Phone:415-491-0888
Mailing Address - Fax:415-456-4865
Practice Address - Street 1:920 NORTHGATE DR
Practice Address - Street 2:SUITE 5
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3429
Practice Address - Country:US
Practice Address - Phone:415-491-0888
Practice Address - Fax:415-456-4865
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7776171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist