Individual provider Active NPI

Kameryn Velvet Rose, LMFT

  • Marriage & Family Therapist
  • Santa Ana, CA
National Provider Identifier
1750861936
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
119932 Issued in CA
Practice address
901 W Civic Center Dr Ste 400
Santa Ana, CA 92703-2383
Phone
(714) 646-1945
NPI assigned
Aug 17, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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 119932 CA Primary

Addresses

Primary practice location

901 W Civic Center Dr Ste 400
Santa Ana, CA 92703-2383

Mailing address

901 W Civic Center Drive Ste 400
#4001
Santa Ana, CA 92703-2383

Other practice location 1

9431 Haven Ave Ste 100
Rancho Cucamonga, CA 91730-5879
Phone (909) 536-1915

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

LicenseStateTypeSpecialty
119932CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1750861936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W CIVIC CENTER DRIVE STE 400",
            "address_2": "#4001",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927032383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W CIVIC CENTER DR STE 400",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927032383",
            "telephone_number": "714-646-1945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9431 Haven Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917305879",
            "country_code": "US",
            "telephone_number": "909-536-1915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "KAMERYN",
        "middle_name": "VELVET",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-17",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "119932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; 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.