Individual provider Active NPI

Lizbeth Eliana Rosas

  • Marriage & Family Therapist
  • Santa Ana, CA
National Provider Identifier
1891025862
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
86778 Issued in CA
Practice address
2212 E 4TH St Ste 301
Santa Ana, CA 92705-3873
Phone
(714) 288-3230
NPI assigned
Jan 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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 86778 CA Primary

Addresses

Primary practice location

2212 E 4TH St Ste 301
Santa Ana, CA 92705-3873

Mailing address

2212 E 4TH St Ste 301
Santa Ana, CA 92705-3873
Phone (714) 288-3230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240103002404 CA Practitioner - Marriage and Family Therapist 2466802434 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86778CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jan 1, 2024 Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

2212 E 4th St
Santa Ana, CA 92705
Phone (714) 288-3230

2212 E 4th St
Ste 301
Santa Ana, CA 92705
Phone (714) 288-3230

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1891025862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 E 4TH ST STE 301",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053873",
            "telephone_number": "714-288-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 E 4TH ST STE 301",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053873",
            "telephone_number": "714-288-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSAS",
        "first_name": "LIZBETH",
        "middle_name": "ELIANA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "86778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.