Active NPI
Grace A Rosales, PHD
- Psychologist
- Los Angeles, CA
National Provider Identifier
1992991798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY21490
- Practice address
- 11301 Wilshire Blvd
#116Ar
Los Angeles, CA 90073-1003 - Phone
- (310) 261-3426
- NPI assigned
- Sep 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY21490 | CA | Primary |
Addresses
Primary practice location
11301 Wilshire Blvd
#116Ar
Los Angeles, CA 90073-1003
Mailing address
2308 Schader Dr
107
Santa Monica, CA 90404-2946
Phone (310) 948-7599
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY21490 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189728000000",
"number": "1992991798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2308 SCHADER DR",
"address_2": "107",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042946",
"telephone_number": "310-948-7599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD",
"address_2": "#116AR",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900731003",
"telephone_number": "310-261-3426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSALES",
"first_name": "GRACE",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-14",
"last_updated": "2007-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY21490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.