Provider Demographics
NPI:1730915612
Name:BAQUEDANO, ROSITA (AMFT)
Entity type:Individual
Prefix:
First Name:ROSITA
Middle Name:
Last Name:BAQUEDANO
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:ROSY
Other - Middle Name:
Other - Last Name:BAQUEDANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AMFT
Mailing Address - Street 1:2000 CRYSTAL SPRINGS RD APT 317
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-4671
Mailing Address - Country:US
Mailing Address - Phone:415-583-7533
Mailing Address - Fax:
Practice Address - Street 1:3626 BALBOA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-2604
Practice Address - Country:US
Practice Address - Phone:415-583-7533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist