Active NPI
Alyssa Rose
- Other Technician
- San Diego, CA
National Provider Identifier
1497299424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- RBT-16-24740
- Practice address
- 6540 Lusk Blvd Ste C256
San Diego, CA 92121-5795 - Phone
- (877) 264-6747
- Fax
- (877) 539-7730
- NPI assigned
- Dec 9, 2016
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | RBT-16-24740 | CA | Primary |
Addresses
Primary practice location
6540 Lusk Blvd Ste C256
San Diego, CA 92121-5795
Mailing address
36 Monterey Blvd Ste a
San Francisco, CA 94131-3235
Phone (877) 264-6747
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-16-24740 | CA | MD | Other Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kyo Autism Therapy, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Daly City, CA
- NPI 1720212749
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481241600000",
"number": "1497299424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 MONTEREY BLVD STE A",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941313235",
"telephone_number": "877-264-6747",
"fax_number": "877-539-7730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6540 LUSK BLVD STE C256",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921215795",
"telephone_number": "877-264-6747",
"fax_number": "877-539-7730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "ALYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-09",
"last_updated": "2016-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "CA",
"license": "RBT-16-24740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.