Individual provider Active NPI

Ivania Haslam Rosado

  • Clinical Social Worker
  • French Camp, CA
National Provider Identifier
1053535971
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
70053 Issued in CA
Practice address
6505 S Manthey Rd
French Camp, CA 95231-9518
Phone
(209) 946-3412
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 70053 CA Primary

Addresses

Primary practice location

6505 S Manthey Rd
French Camp, CA 95231-9518

Mailing address

6505 S Manthey Rd
French Camp, CA 95231-9518
Phone (209) 946-3412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231114002585 CA Practitioner - Clinical Social Worker 2062869910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Juliet AcolatseGroup PAC ID 3577992254, 4 clinicians

Practice addresses (Care Compare)

1201 N Sutter St
Stockton, CA 95202-1506
Phone (209) 855-1006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28590CAMDTechnician/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Juliet Acolatse CurrentSince Oct 25, 2023 Accepting new patients

Locations

1201 N Sutter St
Stockton, CA 95202
Phone (209) 855-1006

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1053535971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6505 S MANTHEY RD",
            "city": "FRENCH CAMP",
            "state": "CA",
            "postal_code": "952319518",
            "telephone_number": "209-946-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 S MANTHEY RD",
            "city": "FRENCH CAMP",
            "state": "CA",
            "postal_code": "952319518",
            "telephone_number": "209-946-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSADO",
        "first_name": "IVANIA",
        "middle_name": "HASLAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "70053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in French Camp, CA

Sources for this page

Verify at the official NPI Registry.