Rooted Life

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ROOTED LIFE

Practice address

6315 Connie Dr
San Diego, CA 92115-2521

Phone

(619) 915-4186

Fax

(619) 810-9201

NPI assigned

Aug 21, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Tracey WilsonNPI 1538671359

Title

Chief Executive Officer

Phone

(619) 357-6472

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracey Wilson, RCFE

  • Nursing Home Administrator
  • San Diego, CA
  • NPI 1538671359
  NPD Authorized official

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1679357685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 GRAND AVE # 802",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921093906",
            "telephone_number": "619-648-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6315 CONNIE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921152521",
            "telephone_number": "619-915-4186",
            "fax_number": "619-810-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTED LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "619-357-6472",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Root Healing SD
• Josie Root
• Olivia Grace Root, RN
• Rooted & Resilient Marriage & Family Therapy, PC
• Rooted and Rising Psychology
• Rooted Relations Speech Therapy, Apc
• Roots & Needles Acupuncture Inc.
• Amber Jean Roper
• Jonathan Geoffrey Roper, MD
• Theodore Samuel Roper, MD

• Community/Behavioral Health Agency in San Diego, CA
• Providers in San Diego, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.