Healthcare Provider Details

I. General information

NPI: 1629986872
Provider Name (Legal Business Name): ROSE TOLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST BLDG 208
SAN FRANCISCO CA
94121-1563
US

IV. Provider business mailing address

369 VISTA GRANDE AVE APT B
DALY CITY CA
94014-3837
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number95202550
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: