Provider Demographics
NPI:1992956759
Name:DALE, ROSE WOO (PHD)
Entity type:Individual
Prefix:
First Name:ROSE
Middle Name:WOO
Last Name:DALE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:WOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:16 S OAKLAND AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2042
Mailing Address - Country:US
Mailing Address - Phone:626-568-3858
Mailing Address - Fax:
Practice Address - Street 1:16 S OAKLAND AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2043
Practice Address - Country:US
Practice Address - Phone:626-568-3858
Practice Address - Fax:626-441-6058
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13839103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical