Organization Active NPI

Marilou C. Rosas Behavioral Health, Inc.

  • Clinical Neuropsychologist
  • Temecula, CA
National Provider Identifier
1871938803
Registry record updated May 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
A97944 Issued in CA
Legal business name
MARILOU C. ROSAS BEHAVIORAL HEALTH, INC.
Practice address
32605 Temecula Pkwy
Suite 219
Temecula, CA 92592-6837
Phone
(951) 506-9112
Fax
(951) 506-9113
NPI assigned
May 3, 2013
Last updated
May 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2013

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

Authorized official

Name
Dr. Marilou Canada Rosas, MDNPI 1053339960
Title
Medical Director
Phone
(951) 506-9112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X A97944 CA Primary

Addresses

Primary practice location

32605 Temecula Pkwy
Suite 219
Temecula, CA 92592-6837

Mailing address

32605 Temecula Pkwy
Suite 219
Temecula, CA 92592-6837
Phone (951) 506-9112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140618002201 CA Part B Supplier - Clinic/Group Practice 3971727603 Receives reassigned benefits from 1 practitioner
Practice locations: Lake Elsinore, CA

National Provider Directory

National Provider Directory

Locations

31569 Canyon Estates Dr
Ste 113
Lake Elsinore, CA 92532
Phone (951) 506-9112

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367539200000",
    "number": "1871938803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32605 TEMECULA PKWY",
            "address_2": "SUITE 219",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925926837",
            "telephone_number": "951-506-9112",
            "fax_number": "951-506-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32605 TEMECULA PKWY",
            "address_2": "SUITE 219",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925926837",
            "telephone_number": "951-506-9112",
            "fax_number": "951-506-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILOU C. ROSAS BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-03",
        "last_updated": "2013-05-03",
        "status": "A",
        "authorized_official_last_name": "ROSAS",
        "authorized_official_first_name": "MARILOU",
        "authorized_official_middle_name": "CANADA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "951-506-9112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "A97944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.