Nicole Marie Rose

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-309472 Issued in CA

Practice address

152 Bluefield Ave
Newbury Park, CA 91320-4229

Phone

(818) 481-8402

NPI assigned

Jan 10, 2023

Last updated

Jan 10, 2023By 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

Electronic endpoints 1

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": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1518671916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 BLUEFIELD AVE",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913204229",
            "telephone_number": "818-481-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 BLUEFIELD AVE",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913204229",
            "telephone_number": "818-481-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "CA",
            "license": "L-309472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Charm",
            "affiliation": "N",
            "address_1": "152 Bluefield Ave",
            "city": "Newbury Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913204229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brooke Rodgers
• Christina Jean Rollins, M.S., CCC-SLP
• Fatima Roman
• Ronald C Thurston MD a Medical Corporation
• Janice Christine Roodsari, RN, IBCLC
• Michelle Rosen
• Amber James Roy, LICSW
• Greg Rubin, D.D.S.
• S&S Medical Supply
• Sam Saadat DDS, D.D.S.

• Lactation Consultant (Non-RN) in Newbury Park, CA
• Providers in Newbury Park, CA by specialty
• Lactation Consultant (Non-RN) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.