Active NPI
Beverly Manley Rose, BEVERLY MANLEY ROSE
- Psychologist
- Los Angeles, CA
National Provider Identifier
1083870760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- CP5261
- Practice address
- 10845 Lindbrook Dr
207
Los Angeles, CA 90024-3042 - Phone
- (310) 208-4122
- NPI assigned
- Aug 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | CP5261 | CA | Primary |
Addresses
Primary practice location
10845 Lindbrook Dr
207
Los Angeles, CA 90024-3042
Mailing address
10845 Lindbrook Dr
207
Los Angeles, CA 90024-3042
Phone (310) 208-4122
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP5261 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217548800000",
"number": "1083870760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10845 LINDBROOK DR",
"address_2": "207",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900243042",
"telephone_number": "310-208-4122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10845 LINDBROOK DR",
"address_2": "207",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900243042",
"telephone_number": "310-208-4122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "BEVERLY",
"middle_name": "MANLEY",
"name_prefix": "Dr.",
"credential": "BEVERLY MANLEY ROSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-01",
"last_updated": "2008-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "CP5261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.