# DR. JONATHON M ROSE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1154382380
- **Gender:** Man
- **Credential:** PH.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103G00000X | Clinical Neuropsychologist | PSY12143 | CA | — |
| 103T00000X | Psychologist | PSY12143 | CA | — |
| 103TA0700X | Adult Development & Aging Psychologist | PSY12143 | CA | Yes |
| 103TC0700X | Clinical Psychologist | PSY12143 | CA | — |
| 103TF0200X | Forensic Psychologist | PSY12143 | CA | — |
| 103TH0100X | Health Service Psychologist | PSY12143 | CA | — |
| 103TR0400X | Rehabilitation Psychologist | PSY12143 | CA | — |

## Other

- **Enumeration date:** 03/29/2006
- **Last updated:** 07/29/2010