Rose, Jonathon M
Rose, Jonathon M is an sole proprietor health care provider with primary practice located at 327 N San Mateo Dr Suite 3, San Mateo CA 94401-2543. He recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Rehabilitation. Behavioral Health & Social Service Providers / Adult Development & Aging is his primary health care specialty. Rose, Jonathon M can be contacted via phone (650) 703-4769.Contact Information
Primary practice address
327 N San Mateo Dr Suite 3
San Mateo CA 94401-2543
Phone: (650) 703-4769
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | PSY12143 | California |
Behavioral Health & Social Service Providers / Adult Development & Aging | 103TA0700X | PSY12143 | California |
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY12143 | California |
Behavioral Health & Social Service Providers / Forensic | 103TF0200X | PSY12143 | California |
Behavioral Health & Social Service Providers / Health Service | 103TH0100X | PSY12143 | California |
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY12143 | California |
Behavioral Health & Social Service Providers / Rehabilitation | 103TR0400X | PSY12143 | California |
Profile Details
NPI number | 1154382380 |
---|---|
LBN Legal business name | Rose, Jonathon M |
Credentials | PH.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Mar 29th, 2006 |
Last updated | Jul 29th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1154382380 | NPPES |
California | MEDICAID | PSY121430 |
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