Healthcare Provider Details

I. General information

NPI: 1932411253
Provider Name (Legal Business Name): MARI FRANCIS DELA ROSA GONZALES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2010
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 POTRERO AVE BLDG 90W93
SAN FRANCISCO CA
94110-2859
US

IV. Provider business mailing address

1625 CARROLL ST.
SAN FRANCISCO CA
94124
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-8412
  • Fax:
Mailing address:
  • Phone: 415-822-8200
  • Fax: 415-822-8203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number95269396
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number223405
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: