Provider Demographics
NPI:1396627048
Name:ROSE, FAITH
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:ROSE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 DESCANSO AVE
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-3615
Mailing Address - Country:US
Mailing Address - Phone:805-450-1642
Mailing Address - Fax:
Practice Address - Street 1:206 N SIGNAL ST STE M
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-2600
Practice Address - Country:US
Practice Address - Phone:805-450-1642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77533225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist