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:
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Health care specialties

SpecialtyCodeLicense #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 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154382380 NPPES
California MEDICAID PSY121430

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