Individual provider Active NPI

Marsh Rose, M.A.

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1629198148
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
29870 Issued in CA
Practice address
2655 Bennett Valley Road
Santa Rosa, CA 95404
Phone
(707) 565-7676
NPI assigned
Mar 29, 2007
Reactivated
Oct 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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 29870 CA Primary

Addresses

Primary practice location

2655 Bennett Valley Road
Santa Rosa, CA 95404

Mailing address

P.O. Box 907
Cloverdale, CA 95425-5427
Phone (707) 565-7676

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
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1629198148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 907",
            "city": "CLOVERDALE",
            "state": "CA",
            "postal_code": "954255427",
            "telephone_number": "707-565-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 BENNETT VALLEY ROAD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95404",
            "telephone_number": "707-565-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "MARSH",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "deactivation_date": "2011-06-28",
        "reactivation_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "29870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.