Active NPI
Diana D. Rose, RTC
- Recreation Therapist
- San Diego, CA
National Provider Identifier
1093986978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 1678-T
- Practice address
- 3853 Rosecrans St
San Diego, CA 92110-3115 - Phone
- (619) 692-8236
- NPI assigned
- Mar 18, 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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 1678-T | CA | Primary |
Addresses
Primary practice location
3853 Rosecrans St
San Diego, CA 92110-3115
Mailing address
3853 Rosecrans St
San Diego, CA 92110-3115
Phone (619) 692-8236
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 |
|---|---|---|---|
| 1678-T | CA | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312243200000",
"number": "1093986978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3853 ROSECRANS ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103115",
"telephone_number": "619-692-8236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3853 ROSECRANS ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103115",
"telephone_number": "619-692-8236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "DIANA",
"middle_name": "D.",
"credential": "RTC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-18",
"last_updated": "2011-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "CA",
"license": "1678-T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.