Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0201X | Pediatric Allergist | SFP0000037 | CA |
N | 2080P0207X | Pediatric Hematology-Oncologist | SFP0000037 | CA |
NPI | 1982288544 |
---|---|
Provider Name | Rosa Bacchetta |
First Address | Palo Alto, CA 94304-1811 |
Second Address | Palo Alto, CA 94304-1614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2021 |
Last Update Date | 10/05/2021 |