Provider Demographics
NPI:1962897488
Name:GOMEZ-LEVYA, ROSA IMELDA (RN)
Entity type:Individual
Prefix:MISS
First Name:ROSA IMELDA
Middle Name:
Last Name:GOMEZ-LEVYA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1798 BAY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:EAST PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-1611
Mailing Address - Country:US
Mailing Address - Phone:650-330-7400
Mailing Address - Fax:650-321-4410
Practice Address - Street 1:1798 BAY RD
Practice Address - Street 2:SUITE A
Practice Address - City:EAST PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-1611
Practice Address - Country:US
Practice Address - Phone:650-330-7400
Practice Address - Fax:650-321-4410
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA782201163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse