Healthcare Provider Details

I. General information

NPI: 1497929889
Provider Name (Legal Business Name): ROSALIE CAROL ROMO RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 BATH ST SUITE202
SANTA BARBARA CA
93105-4351
US

IV. Provider business mailing address

213 GUANTE CIR
SANTA BARBARA CA
93111-1617
US

V. Phone/Fax

Practice location:
  • Phone: 805-687-3744
  • Fax:
Mailing address:
  • Phone: 805-683-1107
  • Fax: 805-683-1679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number150728
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: