| Doctor Name: | MRS. ROSE-MARIE Y NIETO |
| NPI Number: | 1366671257 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | LCS10219 |
| Business Practice Address: | 3294 Royal Dr Suite # 13 Cameron Park, CA - 956828534 |
| Business Phone Number: | 5306774404 |
| Business Fax Number: | 5306774545 |
| Mailing Address: | 3294 Royal Dr, Suite # 13 CAMERON PARK |
| State: | CA |
| Postal Code: | 956828534 |
| Phone Number: | 5306774404 |
| Fax Number: | 5306774545 |
| NPI Enumeration Date: | 07/13/2009 |
| NPI Last Update Date: | 11/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LCS10219 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |