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Contact Information

STACY M DEROSA, R.D.
355 17TH AVE
SAN FRANCISCO, CA94121-2312
 Phone: 631-882-5300
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nutrition, Metabolic

133VN1006X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for STACY M DEROSA · (Female)

NPI # 1992135933
Status Active
Credentials R.D.
Entity Individual
Enumeration date 11/12/2013
Last updated 10/21/2025 - About 8 months ago
Sole proprietor 1 No
Identifiers
  • CA License # 1018194
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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