Individual provider Active NPI

Deena Marie Rose, MFT INTERN

  • Marriage & Family Therapist
  • Roseville, CA
National Provider Identifier
1972020980
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF94864 Issued in CA
Practice address
1528 Eureka Rd Ste 101
Roseville, CA 95661-3047
Phone
(916) 500-4535
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 IMF94864 CA Primary

Addresses

Primary practice location

1528 Eureka Rd Ste 101
Roseville, CA 95661-3047

Mailing address

1528 Eureka Rd Ste 101
Roseville, CA 95661-3047
Phone (916) 500-4535

Other practice location 1

100 Iron Point Cir
Folsom, CA 95630-8599
Phone (916) 500-4535

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
IMF94864CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1972020980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 EUREKA RD STE 101",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613047",
            "telephone_number": "916-500-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 EUREKA RD STE 101",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613047",
            "telephone_number": "916-500-4535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Iron Point Cir",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956308599",
            "country_code": "US",
            "telephone_number": "916-500-4535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "DEENA",
        "middle_name": "MARIE",
        "credential": "MFT INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF94864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.