Bobby G. Rose, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95004731 Issued in CA

Practice address

1955 Long Beach Blvd Ste 200
Long Beach, CA 90806-5501

Phone

(562) 437-6717

NPI assigned

Feb 9, 2015

Last updated

Mar 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Mental Health America of Los Angeles

  dba MHALA Integrated Service Center LB

  • Community/Behavioral Health Agency
  • Long Beach, CA
  • NPI 1326164245
  NPD
• Mental Health America of Los Angeles

  dba MHALA HAP Long Beach

  • Community/Behavioral Health Agency
  • Long Beach, CA
  • NPI 1386760213
  NPD

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1942691266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 LOMA AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908036077",
            "telephone_number": "562-882-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 LONG BEACH BLVD STE 200",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908065501",
            "telephone_number": "562-437-6717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908134513",
            "country_code": "US",
            "telephone_number": "562-285-0149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "BOBBY",
        "middle_name": "G.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-09",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95004731",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "345573",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose Hanna Counseling Services
• Rose Hanna, LMFT
• Rose Park Healthcare Associates,Inc. (Shoreline Healthcare Center)
• Rose Room Home Health Care,Inc.
• Dianne Rose-Deyoung, RNP
• Lindsey Paige Rose, LCSW
• Mark Magnus Rose, MD
• Trinita Denise Rose, AMFT
• Maria Christina Rosel
• Mary Pauleen Mae Seno Rosell, MAOT, OTRP, OTR/L

• Psychiatric/Mental Health Nurse Practitioner in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.