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NPI Code Detail

MEDICARE: MS. ROXANNE ROSEMIRE LCSW

MEDICARE: MS. ROXANNE ROSEMIRE LCSW
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
11041C0700XClinical Social Worker23703CA

General Provider Information

NPI Number : 1942382668
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ROXANNE ROSEMIRE LCSW
Provider Business Mailing Address
First Line : 5945 PACIFIC CENTER BLVD
Second Line : SUITE 510
City : SAN DIEGO
State : CA
Zip : 92121-6305
Country : US
Telephone Number : 619-886-3766
Fax Number : 619-546-0859
Provider Business Practice Location Address
First Line : 5945 PACIFIC CENTER BLVD
Second Line : SUITE 510
City : SAN DIEGO
State : CA
Zip : 92121-6305
Country : US
Telephone Number : 619-886-3766
Fax Number : 619-546-0859
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2006
Last Update Date : 02/18/2011

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