Individual provider Active NPI

Rosa Esther Garcia-Peltoniemi, PHD, LP

  • Clinical Psychologist
  • Minneapolis, MN
National Provider Identifier
1710055991
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP1646 Issued in MN
Practice address
717 E River Pkwy
Minneapolis, MN 55455-0369
Phone
(612) 436-4800
NPI assigned
Dec 4, 2006
Last updated
Feb 19, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP1646 MN Primary

Addresses

Primary practice location

717 E River Pkwy
Minneapolis, MN 55455-0369

Mailing address

1730 Dayton Ave
Saint Paul, MN 55104-6108
Phone (651) 644-9047

Other identifiers 1

IdentifierTypeStateIssuer
LP1646OtherMNPSYCHOLOGY LICENSE

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP1646MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Victims of Torture - Bethesda Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1710055991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 DAYTON AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046108",
            "telephone_number": "651-644-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 E RIVER PKWY",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550369",
            "telephone_number": "612-436-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA-PELTONIEMI",
        "first_name": "ROSA",
        "middle_name": "ESTHER",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP1646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY LICENSE",
            "identifier": "LP1646",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.