Individual provider Active NPI

Rose Mary Amalfitano, PH.D

  • Clinical Psychologist
  • Sacramento, CA
National Provider Identifier
1073629051
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY7906 Issued in CA
Practice address
874 57TH St
Sacramento, CA 95819-3327
Phone
(916) 453-1320
Fax
(916) 453-0572
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY7906 CA Primary

Addresses

Primary practice location

874 57TH St
Sacramento, CA 95819-3327

Mailing address

874 57TH St
Sacramento, CA 95819-3327
Phone (916) 453-1320

Other identifiers 1

IdentifierTypeStateIssuer
PSY7906OtherCASTATE LICENSE NUMBER

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
I20110406000151 CA Practitioner - Clinical Psychologist 6507040102 Practice locations: Sacramento, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

874 57TH St
Sacramento, CA 95819-3327
Phone (916) 453-1320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7906CAMDProfessional Counselor
PSY7906CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Restoring Family Harmony Clinical Past Accepting new patients
Marriage & Family Therapy for Peace of Mind Corporation PastSince Mar 12, 2023 Accepting new patients

Organizations & group practices 2

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073629051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "874 57TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193327",
            "telephone_number": "916-453-1320",
            "fax_number": "916-453-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "874 57TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193327",
            "telephone_number": "916-453-1320",
            "fax_number": "916-453-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMALFITANO",
        "first_name": "ROSE MARY",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY7906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PSY7906",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.