Provider Demographics
NPI:1144058561
Name:USEDA, ROSALITA CARMELA
Entity type:Individual
Prefix:
First Name:ROSALITA
Middle Name:CARMELA
Last Name:USEDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W FILLMORE ST APT 314
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003-0022
Mailing Address - Country:US
Mailing Address - Phone:707-816-7443
Mailing Address - Fax:
Practice Address - Street 1:601 W FILLMORE ST APT 314
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-0022
Practice Address - Country:US
Practice Address - Phone:707-816-7443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool