Active NPI
Angela Rose, LMFT 98940
- Marriage & Family Therapist
- Soquel, CA
National Provider Identifier
1750790366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 98940
- Practice address
- 2901 Park Ave Ste B10
Soquel, CA 95073-2831 - Phone
- (831) 471-7165
- NPI assigned
- Aug 7, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 70937 | CA | |
| Marriage & Family Therapist | 106H00000X | 98940 | CA | Primary |
Addresses
Primary practice location
2901 Park Ave Ste B10
Soquel, CA 95073-2831
Mailing address
PO Box 576
Felton, CA 95018-0576
Phone (831) 471-7165
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70937 | CA | MD | Social Worker |
| 98940 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561075200000",
"number": "1750790366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 576",
"city": "FELTON",
"state": "CA",
"postal_code": "950180576",
"telephone_number": "831-471-7165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 PARK AVE STE B10",
"city": "SOQUEL",
"state": "CA",
"postal_code": "950732831",
"telephone_number": "831-471-7165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "ANGELA",
"credential": "LMFT 98940",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-07",
"last_updated": "2019-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "70937",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "98940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Soquel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.