JORDAN ROSE

SANTA ROSA, CA
NPI1164095964
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CA  95025794)
Additional Taxonomies163W00000X Registered Nurse
(Licence: CA  95224646)
Enumeration Date2021-07-20
Last Update Date2024-06-26
Business Address
JORDAN ROSE
1287 FULTON RD
SANTA ROSA, CA 95401-4923
Phone number: 707-800-7700
Mailing Address
JORDAN ROSE
PO BOX 464
MILL VALLEY, CA 94942-0464
Phone number: 707-800-7700