Individual
JOSEPH JACK ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1001 POTRERO AVE, SAN FRANCISCO, CA 94110
(415) 206-8125
(415) 206-5733
Mailing address
1001 POTRERO AVE, SAN FRANCISCO, CA 94110
(415) 206-8125
(415) 206-5733
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95103994
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95103994
RN
CA
Enumeration date
09/02/2018
Last updated
09/02/2018
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