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NPI Code Detail

MEDICARE: ROSABY SEPULVEDA

MEDICARE: ROSABY SEPULVEDA
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1316872054
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSABY SEPULVEDA
Provider Business Mailing Address
First Line : 401 HIGHLAND AVE
Second Line :
City : SOMERVILLE
State : MA
Zip : 02144-2516
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 401 HIGHLAND AVE
Second Line :
City : SOMERVILLE
State : MA
Zip : 02144-2516
Country : US
Telephone Number : 413-657-0276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “ ROSABY SEPULVEDA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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