Provider Demographics
NPI:1285700856
Name:QUINONES, ROSE MARIE (PA-C)
Entity type:Individual
Prefix:MS
First Name:ROSE
Middle Name:MARIE
Last Name:QUINONES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1171 MISSION ST.
Mailing Address - Street 2:MEDICAL RESPITE
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103
Mailing Address - Country:US
Mailing Address - Phone:415-734-4215
Mailing Address - Fax:415-734-4218
Practice Address - Street 1:1171 MISSION ST.
Practice Address - Street 2:MEDICAL RESPITE
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103
Practice Address - Country:US
Practice Address - Phone:415-734-4215
Practice Address - Fax:415-734-4218
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11694363A00000X
CAPA11694207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11694OtherPA LICENSE
CAMQ1311101OtherDEA LICENSE