Provider Demographics
NPI:1902257918
Name:COLOSIO, ROSALIE (CLINICAL PSYD INTERN)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:
Last Name:COLOSIO
Suffix:
Gender:F
Credentials:CLINICAL PSYD INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 BARTLETT AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3606
Mailing Address - Country:US
Mailing Address - Phone:925-200-2613
Mailing Address - Fax:
Practice Address - Street 1:1005 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-1148
Practice Address - Country:US
Practice Address - Phone:510-217-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent