Individual provider Active NPI

Angelyn Nicole Rose, LMFT

  • Marriage & Family Therapist
  • Santa Monica, CA
National Provider Identifier
1356119549
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
154941 Issued in CA
Practice address
3019 Ocean Park Blvd # 234
Santa Monica, CA 90405-3004
Phone
(424) 241-3896
NPI assigned
Dec 18, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 11161 CA
Marriage & Family Therapist 106H00000X 154941 CA Primary

Addresses

Primary practice location

3019 Ocean Park Blvd # 234
Santa Monica, CA 90405-3004

Mailing address

3019 Ocean Park Blvd # 234
Santa Monica, CA 90405-3004
Phone (424) 241-3896

Other practice location 1

5601 W Slauson Ave Ste 192
Culver City, CA 90230-6569
Phone (424) 331-9070

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

LicenseStateTypeSpecialty
154941CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brighter Tomorrow Family Therapy Inc Mental Health CurrentSince Dec 14, 2025 Accepting new patients
Kohan International Foundation Marriage & Family Therapist CurrentSince Dec 1, 2023 Accepting new patients

Locations

5601 W Slauson Ave
Ste 192
Culver City, CA 90230
Phone (310) 968-6648

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1356119549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 OCEAN PARK BLVD # 234",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053004",
            "telephone_number": "424-241-3896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 OCEAN PARK BLVD # 234",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053004",
            "telephone_number": "424-241-3896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5601 W Slauson Ave Ste 192",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902306569",
            "country_code": "US",
            "telephone_number": "424-331-9070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "ANGELYN",
        "middle_name": "NICOLE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-18",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "11161",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "154941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; 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.