Michele Anne Roush, MA, RASI

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2012668 Issued in CA

Practice address

1887 Monterey Hwy Ste 225
San Jose, CA 95112

Phone

(408) 706-6855

NPI assigned

Nov 5, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Encompass Community Services

  • Mental Illness Community Based Residential Treatment Facility
  • Santa Cruz, CA
  • NPI 1174746408
  NPD (past)

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1194026294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16782 VON KARMAN AVE STE 11",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062417",
            "telephone_number": "949-833-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 MONTEREY HWY STE 225",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95112",
            "telephone_number": "408-706-6855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3035 Prather Ln",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950651801",
            "country_code": "US",
            "telephone_number": "831-459-0444",
            "fax_number": "831-459-0665",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3035 Prather Ln",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950651801",
            "country_code": "US",
            "telephone_number": "831-459-0444",
            "fax_number": "831-459-0665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUSH",
        "first_name": "MICHELE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MA, RASI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-05",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "2012668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN# SANTA CRUZ CA",
            "identifier": "ZZZ92069Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Margaret Rottjakob, D.D.S
• Stephen L Rottjakob, D.D.S.
• Gregory Paul Roumbanis, LMFT
• Brianna Rounds, RN
• Cherise Roundy
• Ibrahim Rouzyi, PA
• Natalie Rovero
• Kaye-Ailsa F Rowan, LMFT
• Dale Rowe
• Elizabeth Rowe

• Clinical Psychologist in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.

Verify at the official NPI Registry.