Healthcare Provider Details

I. General information

NPI: 1720910235
Provider Name (Legal Business Name): ROSIE CRUZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2244 NEVADA GLN
ESCONDIDO CA
92029-4009
US

IV. Provider business mailing address

2244 NEVADA GLN
ESCONDIDO CA
92029-4009
US

V. Phone/Fax

Practice location:
  • Phone: 760-803-2005
  • Fax:
Mailing address:
  • Phone: 760-803-2005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number860197
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number817985
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: