Organization Active NPI

Rooted Minds, Inc

  • Clinical Psychologist
  • Rancho Cucamonga, CA
National Provider Identifier
1487478939
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
ROOTED MINDS, INC
Practice address
11175 Azusa CT Ste 110
Rancho Cucamonga, CA 91730-4933
Phone
(626) 317-9579
NPI assigned
Nov 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Dr. Monika BotrosNPI 1467966598
Title
Owner
Phone
(626) 317-9579

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

11175 Azusa CT Ste 110
Rancho Cucamonga, CA 91730-4933

Mailing address

11175 Azusa CT Ste 110
Rancho Cucamonga, CA 91730-4933
Phone (626) 317-9577

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1487478939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11175 AZUSA CT STE 110",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304933",
            "telephone_number": "626-317-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11175 AZUSA CT STE 110",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304933",
            "telephone_number": "626-317-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTED MINDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "BOTROS",
        "authorized_official_first_name": "MONIKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-317-9579",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.