Mary Theresa Rose

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

34407 Issued in CA

Practice address

1965 Live Oak Blvd
Yuba City, CA 95991-8850

Phone

(530) 822-7209

NPI assigned

Jun 20, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1624147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624147200000",
    "number": "1659940104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 LIVE OAK BLVD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959918850",
            "telephone_number": "530-822-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 LIVE OAK BLVD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959918850",
            "telephone_number": "530-822-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-20",
        "last_updated": "2021-06-20",
        "certification_date": "2021-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "34407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Gloria Rosa-Diniz
• Kitrice Rosa, LMFT
• Teena Marie Rosales
• Jennifer A Rose
• John B Rose, M.D.
• Annie Ross
• Deja Regina Marie Ross
• Jaime Rossier
• Kristina Marie Ott Rossiter, ASW
• Kayla Michelle Rowland

• Licensed Psychiatric Technician in Yuba City, CA
• Providers in Yuba City, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2021; 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.