Individual provider Active NPI

Craig Steven Rosen, PH.D.

  • Clinical Psychologist
  • Menlo Park, CA
National Provider Identifier
1154416634
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16786 Issued in CA
Practice address
795 Willow Road
Vapahcs (334-PTSD)
Menlo Park, CA 94025
Phone
(650) 493-5000
Fax
(650) 617-2684
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

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 PSY16786 CA Primary

Addresses

Primary practice location

795 Willow Road
Vapahcs (334-PTSD)
Menlo Park, CA 94025

Mailing address

795 Willow Road
Vapahcs (334-PTSD)
Menlo Park, CA 94025
Phone (650) 493-5000

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY16786CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154416634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 WILLOW ROAD",
            "address_2": "VAPAHCS (334-PTSD)",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "94025",
            "telephone_number": "650-493-5000",
            "fax_number": "650-617-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 WILLOW ROAD",
            "address_2": "VAPAHCS (334-PTSD)",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "94025",
            "telephone_number": "650-493-5000",
            "fax_number": "650-617-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "CRAIG",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.