Provider Demographics
NPI:1255219721
Name:ROSAS SAFFARI, LEO (WHNP-BC)
Entity type:Individual
Prefix:
First Name:LEO
Middle Name:
Last Name:ROSAS SAFFARI
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:LEO
Other - Middle Name:
Other - Last Name:ROSAS VICKERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2362 AMERICAN RIVER DR APT 109
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-7034
Mailing Address - Country:US
Mailing Address - Phone:916-342-5614
Mailing Address - Fax:
Practice Address - Street 1:678 N WILSON WAY # G
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95205-4272
Practice Address - Country:US
Practice Address - Phone:209-466-2081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-23
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036823363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health