Provider Demographics
NPI:1447334883
Name:ROSS, ANNE TERRI (RPA-C)
Entity type:Individual
Prefix:MISS
First Name:ANNE
Middle Name:TERRI
Last Name:ROSS
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:TERRI
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:425 N DATE ST
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3413
Mailing Address - Country:US
Mailing Address - Phone:760-520-8340
Mailing Address - Fax:760-737-6945
Practice Address - Street 1:39 AUBURN PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-1946
Practice Address - Country:US
Practice Address - Phone:718-834-6974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010221363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant