Basic Information
| Provider Information | |||||||||
| NPI: | 1073645677 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WARREN | ||||||||
| FirstName: | ROSALYN | ||||||||
| MiddleName: | SHEREE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3906 N FLAME TREE AVE | ||||||||
| Address2: | |||||||||
| City: | RIALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923773511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094557497 | ||||||||
| FaxNumber: | 9096209793 | ||||||||
| Practice Location | |||||||||
| Address1: | 1529 E PALMDALE BLVD STE 150 | ||||||||
| Address2: | |||||||||
| City: | PALMDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935502038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6615751800 | ||||||||
| FaxNumber: | 6612656025 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2007 | ||||||||
| LastUpdateDate: | 09/09/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 20937 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.