Provider Demographics
NPI:1528637071
Name:LOW, ROSEMARY SHIU CHING
Entity type:Individual
Prefix:
First Name:ROSEMARY SHIU CHING
Middle Name:
Last Name:LOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:
Other - Last Name:LOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1132 DANIEL DR
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-5468
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1132 DANIEL DR
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-5468
Practice Address - Country:US
Practice Address - Phone:808-214-0146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-20
Last Update Date:2021-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI13403225700000X
CA53085225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist