Individual provider Active NPI

Sonny Rose, R.N., MFT INTERN

  • Marriage & Family Therapist
  • Richmond, CA
National Provider Identifier
1578629853
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFIL42275 Issued in CA
Practice address
1001 South 57TH Street
Richmond, CA 94804
Phone
(925) 895-5716
Fax
(510) 374-7033
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFIL42275 CA Primary

Addresses

Primary practice location

1001 South 57TH Street
Richmond, CA 94804

Mailing address

1001 South 57TH Street
Richmond, CA 94804
Phone (925) 895-5716

Other names 1

  • Marcia Rose Former name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
MFIL42275CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1578629853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 SOUTH 57TH STREET",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "94804",
            "telephone_number": "925-895-5716",
            "fax_number": "510-374-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 SOUTH 57TH STREET",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "94804",
            "telephone_number": "925-895-5716",
            "fax_number": "510-374-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "SONNY",
        "credential": "R.N., MFT INTERN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFIL42275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCIA",
            "last_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Richmond, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; 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.