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General NPI Number Information
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NPI Number | 1548851546
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Entity Type | Individual
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Provider Name | PHOEBE ROSSITER RN, PHN
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Gender | Female
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Dates
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Enumeration Date | 02/01/2021
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 384 14TH ST
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City | OAKLAND
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State | CA
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Zip | 94612-3211
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Country | US
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Telephone | 510-504-1297
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Fax |
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Provider Business Mailing Address
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Address Line | 325 HENRY ST
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City | OAKLAND
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State | CA
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Zip | 94607-1227
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Country | US
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Telephone | 510-910-1121
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 745411
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License Number State | CA
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