Organization
SANTA ROSA HEALTH ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA SIFUENTES ORTIZ FNP (CFO, OWNER)
(323) 216-2068
Entity
Organization
Contact information
Practice address
5011 WHITTIER BLVD, LOS ANGELES, CA 90022-3116
(323) 981-2933
(323) 981-2935
Mailing address
5011 WHITTIER BLVD, LOS ANGELES, CA 90022-3116
(323) 981-2933
(323) 981-2935
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A41270
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15206
CA FAMILY NURSE PRACTITIONER LICENSE
CA
01
—
7205
CA FAMILY NURSE PRACTITIONER LICENSE
CA
01
—
A41270
CA MEDICAL LICENSE
CA
01
—
PA19011
CA PHYSICIAN ASSISTANT LICENSE
CA
Enumeration date
05/16/2012
Last updated
05/16/2012
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