Provider Information for 1518026640
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Ms. KATHY JO ROSE MFT
Sex: Female
NPI: 1518026640
Last Updated: 2022-12-01
Certification Date: 2022-12-01
Certification Date: 2022-12-01
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1518026640 | ||||||||||||
| Enumeration Date | 2006-12-06 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 9965 SCRIPPS WESTVIEW WAY UNIT 35 SAN DIEGO, CA 92131-2482 United States Phone: 858-356-8243 | Fax: | ||||||||||||
| Primary Practice Address | 9965 SCRIPPS WESTVIEW WAY UNIT 35 SAN DIEGO, CA 92131-2482 United States Phone: 858-356-8243 | Fax: | ||||||||||||
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