Individual
DR. CORAL ROSEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP, AGNP
Contact information
Practice address
8851 CENTER DR STE 408, LA MESA, CA 91942-3076
(619) 583-1174
Mailing address
9395 HARRITT RD SPC 111, LAKESIDE, CA 92040-3530
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN95169759
CA
363LF0000X
Family Nurse Practitioner
Primary
95026375
CA
363LG0600X
Gerontology Nurse Practitioner
95026375
CA
Other
Enumeration date
07/26/2023
Last updated
08/23/2023
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