Provider Demographics
NPI:1962058172
Name:HANCOCK, ROSAMOND (FNP)
Entity type:Individual
Prefix:
First Name:ROSAMOND
Middle Name:
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16773 BERNARDO CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2525
Mailing Address - Country:US
Mailing Address - Phone:858-451-2630
Mailing Address - Fax:
Practice Address - Street 1:16773 BERNARDO CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2525
Practice Address - Country:US
Practice Address - Phone:858-451-2630
Practice Address - Fax:602-307-0080
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ230050363LF0000X
CA95015699363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily