Provider Demographics
NPI:1699543066
Name:ESTROPIA, ROSELLE
Entity type:Individual
Prefix:
First Name:ROSELLE
Middle Name:
Last Name:ESTROPIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3081 TEAGARDEN ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-5720
Mailing Address - Country:US
Mailing Address - Phone:510-347-4620
Mailing Address - Fax:
Practice Address - Street 1:3081 TEAGARDEN ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-5720
Practice Address - Country:US
Practice Address - Phone:510-347-4620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-15
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health