Healthcare Provider Details

I. General information

NPI: 1518318088
Provider Name (Legal Business Name): ROSA VELASQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1002 E GRAND AVE
ESCONDIDO CA
92025-4605
US

IV. Provider business mailing address

3225 ANCHOR WAY APT 303
OCEANSIDE CA
92054-3876
US

V. Phone/Fax

Practice location:
  • Phone: 760-741-2660
  • Fax:
Mailing address:
  • Phone: 760-893-6930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: