MEDICARE: ALICE LUCINDA DEL ROSARIO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	A38979	CA
2	2084P0800X	Psychiatry Physician	A38979	CA

General Provider Information

NPI Number	:	1215048558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE LUCINDA DEL ROSARIO MD

Provider Business Mailing Address
First Line	:	3835 N FREEWAY BLVD STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-1954
Country	:	US
Telephone Number	:	916-576-7900
Fax Number	:	916-285-0338

Provider Business Practice Location Address
First Line	:	29899 BALENTINE DR
Second Line	:	STE 210
City	:	NEWARK
State	:	CA
Zip	:	94560-5361
Country	:	US
Telephone Number	:	510-657-9700
Fax Number	:	510-657-7335

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	03/29/2018

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