DR. JONATHON M ROSE PH.D. NPI 1154382380

NPI Information

  • NPI: 1154382380
  • Provider Name: DR. JONATHON M ROSE, PH.D.
  • Classification: Psychologist - 103TA0700X
  • Specialization: Adult Development & Aging
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 327 N SAN MATEO DR
    SUITE 3
    SAN MATEO, CA
    ZIP 94401
  • Phone: (650) 703-4769

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NPI Details

DR. Jonathon M Rose, PH.D. is an adult development and aging psychologist in San Mateo, CA. The provider is a psychologist who specializes in geropsychology, which applies the knowledge and methods of psychology to understanding and helping older persons and their families to maintain well-being, overcome problems and achieve maximum potential during later life. Professional geropsychology appreciates the wide diversity among older adults, the complex ethical issues that can arise in geriatric practice and the importance of interdisciplinary models of care. DR. Jonathon M Rose, PH.D. NPI is 1154382380. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

327 N SAN MATEO DR
SUITE 3
SAN MATEO, CA
ZIP 94401-543
Phone: (650) 703-4769

The NPI 1154382380 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 3/29/2006 and was last updated on 7/29/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103G00000XClinical NeuropsychologistPSY12143CALIFORNIANo
2103TC0700XPsychologistClinicalPSY12143CALIFORNIANo
3103TF0200XPsychologistForensicPSY12143CALIFORNIANo
4103TH0100XPsychologistHealth ServicePSY12143CALIFORNIANo
5103T00000XPsychologistPSY12143CALIFORNIANo
6103TR0400XPsychologistRehabilitationPSY12143CALIFORNIANo
7103TA0700XPsychologistAdult Development & AgingPSY12143CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PSY121430MEDICAIDCALIFORNIA
2R23961MEDICARE UPINCALIFORNIA
30PL121431MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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