DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: ELLA ROSE NMN LEE RADT

MEDICARE: ELLA ROSE NMN LEE RADT
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
1175T00000XPeer SpecialistR1465840422CA
2101YA0400XAddiction (Substance Use Disorder) CounselorR1465840422CA

General Provider Information

NPI Number : 1568192953
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLA ROSE NMN LEE RADT
Provider Business Mailing Address
First Line : 3594 4TH AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-4989
Country : US
Telephone Number : 619-296-1151
Fax Number : 619-296-6218
Provider Business Practice Location Address
First Line : 3594 4TH AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-4989
Country : US
Telephone Number : 619-296-1151
Fax Number : 619-296-6218
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2022
Last Update Date : 10/19/2022

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:
211 CALLE MORSE
ARROYO, PR
00714-2350
Practice Phone: 787-839-3980
Practice Fax: 787-271-2515
1336505858 — MRS. WENDY DAWN PARKER CADC-CAS
Practice Location Address:
3594 4TH AVE
SAN DIEGO, CA
92103-4989
Practice Phone: 619-296-1151
Practice Fax: 619-296-6218
1811461320 — LAUREN ASH-DONOHO CADTP#8785
Practice Location Address:
3594 4TH AVE
SAN DIEGO, CA
92103-4989
Practice Phone: 619-296-1151
Practice Fax: 619-296-6218
1699408872 — PAULINE GARCIA
Practice Location Address:
3594 4TH AVE
SAN DIEGO, CA
92103-4989
Practice Phone: 619-296-1151
Practice Fax:
1689393043 — MELONEY ROCHELLE GARCIA
Practice Location Address:
3594 4TH AVE
SAN DIEGO, CA
92103-4989
Practice Phone: 619-296-1151
Practice Fax:
1932824158 — LISA WALTER RADT
Practice Location Address:
3594 4TH AVE
SAN DIEGO, CA
92103-4989
Practice Phone: 619-296-1151
Practice Fax: 619-296-1151

Directions to “ ELLA ROSE NMN LEE RADT” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.