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General NPI Number Information
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NPI Number | 1598604340
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Entity Type | Individual
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Provider Name | JUSTIN ZACHARY ROSS RN
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Gender | Male
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 1401 BROADWAY
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City | SAN DIEGO
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State | CA
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Zip | 92101-5710
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Country | US
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Telephone | 619-276-8112
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 421141
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City | SAN DIEGO
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State | CA
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Zip | 92142-1141
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Country | US
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Telephone | 619-276-8112
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 95438322
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License Number State | CA
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