Provider Demographics
NPI:1770285611
Name:BERNAL, ROSALINDA
Entity type:Individual
Prefix:
First Name:ROSALINDA
Middle Name:
Last Name:BERNAL
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 1:1699 BEACHWOOD DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95407-7510
Mailing Address - Country:US
Mailing Address - Phone:707-292-3286
Mailing Address - Fax:
Practice Address - Street 1:1699 BEACHWOOD DR UNIT A
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95407-7510
Practice Address - Country:US
Practice Address - Phone:707-292-3286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula