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DR. JONATHON M ROSE PH.D.

Clinical Neuropsychologist

San Mateo, California

Provider NPI: 1154382380

Provider Information:
DR. JONATHON M ROSE PH.D.
Gender: M
Sole Proprietor


Practice Location:
327 N SAN MATEO DR SUITE 3 SAN MATEO, CA 94401 US
Tel: 650-703-4769  Fax: --

Business Mailing Address:
411 HILLCREST RD  SAN CARLOS, CA 94070 US
Tel: 650-703-4769  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
CAPSY12143
N103T00000XBehavioral Health & Social Service Providers
Psychologist
CAPSY12143
Y103TA0700XBehavioral Health & Social Service Providers
Psychologist
CAPSY12143
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
CAPSY12143
N103TF0200XBehavioral Health & Social Service Providers
Psychologist
CAPSY12143
N103TH0100XBehavioral Health & Social Service Providers
Psychologist
CAPSY12143
N103TR0400XBehavioral Health & Social Service Providers
Psychologist
CAPSY12143

Other Provider Identifiers:

IssuerNumberStateType
PSY121430CA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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