Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT36199 | CA |
NPI | 1003144668 |
---|---|
Provider Name | Dr. Maureen B Rosa |
First Address | San Jose, CA 95135-1503 |
Second Address | Sunnyvale, CA 94087-2657 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2009 |
Last Update Date | 08/03/2013 |