Active NPI
Jennifer Elizabeth De la Rosa
- Rehabilitation Practitioner
- Van Nuys, CA
National Provider Identifier
1194359414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 14515 Hamlin St
Van Nuys, CA 91411-1686 - Phone
- (818) 989-7475
- NPI assigned
- Feb 25, 2020
- 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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
14515 Hamlin St
Van Nuys, CA 91411-1686
Mailing address
44262 Gingham Ave
Lancaster, CA 93535-3732
Phone (661) 492-0193
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22540000X | Medicaid | CA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585180800000",
"number": "1194359414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44262 GINGHAM AVE",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935353732",
"telephone_number": "661-492-0193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14515 HAMLIN ST",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914111686",
"telephone_number": "818-989-7475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA ROSA",
"first_name": "JENNIFER",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-25",
"last_updated": "2020-03-26",
"certification_date": "2020-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "22540000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.