Provider Demographics
NPI:1043527211
Name:BIGLARIPOOR, ROSY (MA)
Entity type:Individual
Prefix:
First Name:ROSY
Middle Name:
Last Name:BIGLARIPOOR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 MOORPARK AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-1707
Mailing Address - Country:US
Mailing Address - Phone:408-605-1205
Mailing Address - Fax:
Practice Address - Street 1:4100 MOORPARK AVE STE 106
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-1707
Practice Address - Country:US
Practice Address - Phone:408-605-1205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA940258168OtherMEDICAL