Active NPI
Jaclyn Rose
- Occupational Therapist
- National City, CA
National Provider Identifier
1124586466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 19736
- Practice address
- 220 E 24TH St
National City, CA 91950-6705 - Phone
- (619) 474-6741
- NPI assigned
- Mar 5, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 19736 | CA | Primary |
Addresses
Primary practice location
220 E 24TH St
National City, CA 91950-6705
Mailing address
822 San Juan PL Apt 1
San Diego, CA 92109-7356
Phone (848) 459-0916
Other practice location 1
5945 Pacific Center Blvd Ste 510
San Diego, CA 92121-6305
Phone (858) 695-9444
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 |
|---|---|---|---|
| 19736 | CA | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552867200000",
"number": "1124586466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "822 SAN JUAN PL APT 1",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921097356",
"telephone_number": "848-459-0916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 E 24TH ST",
"city": "NATIONAL CITY",
"state": "CA",
"postal_code": "919506705",
"telephone_number": "619-474-6741"
}
],
"practiceLocations": [
{
"address_1": "5945 Pacific Center Blvd Ste 510",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921216305",
"country_code": "US",
"telephone_number": "858-695-9444",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSE",
"first_name": "JACLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-05",
"last_updated": "2019-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "19736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in National City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.