Healthcare Provider Details

I. General information

NPI: 1346919800
Provider Name (Legal Business Name): JANET ROSALES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 GATEWAY PL STE 230E
SAN JOSE CA
95110-3719
US

IV. Provider business mailing address

2001 GATEWAY PL
SAN JOSE CA
95110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 209-704-1852
  • Fax:
Mailing address:
  • Phone: 209-704-1852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: