Individual provider Active NPI

Sasha Micaella Rojas

  • Clinical Psychologist
  • Boise, ID
National Provider Identifier
1790307163
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY61062191 Issued in WA
Practice address
444 W Fort St FL 2
Boise, ID 83702-4535
Phone
(208) 422-1018
NPI assigned
May 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X
Clinical Psychologist 103TC0700X PY61062191 WA Primary

Addresses

Primary practice location

444 W Fort St FL 2
Boise, ID 83702-4535

Mailing address

444 W Fort St FL 2
Boise, ID 83702-4535
Phone (208) 422-1018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY61062191WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1790307163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 W FORT ST FL 2",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024535",
            "telephone_number": "208-422-1018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 W FORT ST FL 2",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024535",
            "telephone_number": "208-422-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROJAS",
        "first_name": "SASHA",
        "middle_name": "MICAELLA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-08",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61062191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.