Healthcare Provider Details

I. General information

NPI: 1760695894
Provider Name (Legal Business Name): JOANA MARIA DA ROSA D.C., D.A.B.C.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 BUSH ST STE. 388
SAN FRANCISCO CA
94108-3706
US

IV. Provider business mailing address

745 SWEET WATER DR
DANVILLE CA
94506-1225
US

V. Phone/Fax

Practice location:
  • Phone: 415-391-4919
  • Fax: 415-391-4984
Mailing address:
  • Phone: 925-736-5248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number17662
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: