| Doctor Name: | ROSEMARY CHARMAINE DACOSTA |
| NPI Number: | 1003062548 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 160 W. Cerritos Building 4 Anaheim, CA - 92805 |
| Business Phone Number: | 7146876710 |
| Business Fax Number: | |
| Mailing Address: | 21204 Jasmines Way, LAKE FOREST |
| State: | CA |
| Postal Code: | 92630 |
| Phone Number: | 9492322290 |
| Fax Number: | |
| NPI Enumeration Date: | 08/15/2008 |
| NPI Last Update Date: | 08/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |