Healthcare Provider Details

I. General information

NPI: 1609149434
Provider Name (Legal Business Name): PAMELA GABRIEL ROSARIO PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41197 GOLDEN GATE CIR STE 107
MURRIETA CA
92562-6998
US

IV. Provider business mailing address

41197 GOLDEN GATE CIR STE 107
MURRIETA CA
92562-6998
US

V. Phone/Fax

Practice location:
  • Phone: 951-215-6747
  • Fax: 619-268-5255
Mailing address:
  • Phone: 951-215-6747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21617
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number21617
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number571234
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: