Provider Demographics
NPI:1215196902
Name:ROSE, ARTHUR (MFT)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:
Last Name:ROSE
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MIDDLEFIELD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4002
Mailing Address - Country:US
Mailing Address - Phone:650-327-9411
Mailing Address - Fax:415-655-9435
Practice Address - Street 1:200 MIDDLEFIELD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4002
Practice Address - Country:US
Practice Address - Phone:650-327-9411
Practice Address - Fax:415-655-9435
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMY20975106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist