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General NPI Number Information
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NPI Number | 1598564692
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Entity Type | Individual
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Provider Name | YANELI NOEMI ROSALES
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Gender | Female
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 1155 THIRD AVE
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City | CHULA VISTA
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State | CA
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Zip | 91911-3136
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Country | US
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Telephone | 619-498-8260
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Fax | 619-498-8265
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Provider Business Mailing Address
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Address Line | 2420 PALM AVE SPC 5
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City | SAN DIEGO
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State | CA
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Zip | 92154-1431
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Country | US
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Telephone | 619-636-8865
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | R15494190125
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License Number State | CA
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