Carla Gayl De Rose, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT29941 Issued in CA

Practice address

5050 Sunrise Blvd Ste C5
Fair Oaks, CA 95628-4942

Phone

(916) 966-6615

Fax

(916) 966-6152

NPI assigned

Mar 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417087222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4876 PAPAYA DR",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956284430",
            "telephone_number": "916-966-6152",
            "fax_number": "916-966-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 SUNRISE BLVD STE C5",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956284942",
            "telephone_number": "916-966-6615",
            "fax_number": "916-966-6152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ROSE",
        "first_name": "CARLA",
        "middle_name": "GAYL",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT29941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Fair Oaks, CA
• Providers in Fair Oaks, CA by specialty
• Marriage & Family Therapist in California

• 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.