MEDICARE: ROSALIND S. NG NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	15196	CA

General Provider Information

NPI Number	:	1154322311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSALIND S. NG NP

Provider Business Mailing Address
First Line	:	5017 GOLDEN NUGGET WAY
Second Line	:
City	:	OAK PARK
State	:	CA
Zip	:	91377-4766
Country	:	US
Telephone Number	:	805-328-4168
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 UNIVERSITY DR
Second Line	:	CAL STATE UNIVERSITY CHANNEL ISLANDS STUDENT HEALTH
City	:	CAMARILLO
State	:	CA
Zip	:	93012-8599
Country	:	US
Telephone Number	:	805-437-8828
Fax Number	:	805-437-8829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/17/2023

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