Provider Demographics
NPI:1952584880
Name:SIEMENS, ROSA A (RD, CDCES)
Entity type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:A
Last Name:SIEMENS
Suffix:
Gender:F
Credentials:RD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3376 N SAN MARIN DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AZ
Mailing Address - Zip Code:85132-7543
Mailing Address - Country:US
Mailing Address - Phone:831-998-0494
Mailing Address - Fax:
Practice Address - Street 1:3376 N SAN MARIN DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AZ
Practice Address - Zip Code:85132-7543
Practice Address - Country:US
Practice Address - Phone:831-998-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX708187133V00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered