Healthcare Provider Details

I. General information

NPI: 1225237829
Provider Name (Legal Business Name): MS. ROSEMARY BARAJA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2523 W 7TH ST
LOS ANGELES CA
90057-3801
US

IV. Provider business mailing address

16345 E BRIDGER ST
COVINA CA
91722-3303
US

V. Phone/Fax

Practice location:
  • Phone: 213-480-1557
  • Fax: 213-480-1182
Mailing address:
  • Phone: 323-710-6263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: