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NPI Code Detail

MEDICARE: NINO RALPH DE LA CRUZ ROSALES

MEDICARE: NINO RALPH DE LA CRUZ ROSALES
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
1373H00000XDay Training/Habilitation Specialist
2225400000XRehabilitation Practitioner
3101Y00000XCounselor

General Provider Information

NPI Number : 1851614101
Entity Type Code : Individual
Provider Name (Legal Business Name) : NINO RALPH DE LA CRUZ ROSALES
Provider Business Mailing Address
First Line : 1801 VICENTE ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94116-2923
Country : US
Telephone Number : 415-681-3211
Fax Number :
Provider Business Practice Location Address
First Line : 2681 28TH AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94116-2912
Country : US
Telephone Number : 415-681-3211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2010
Last Update Date : 05/21/2025

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Directions to “ NINO RALPH DE LA CRUZ ROSALES ” Practice Location

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