MR. BRANDON LEE ROSE (NPI# 1942606108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942606108 |
| Entity Type | Individual |
| Full Name | MR. BRANDON LEE ROSE |
| Credential | B.S. DEGREE |
| Practice Address |
9207 Mammath Peak Cir Stockton CA 95212-3212 |
| Practice Telephone | 2096237456 |
| Practice Fax Number | 2095941872 |
| Mailing Telephone | 2096237456 |
| Mailing Fax Number | 2095941872 |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2014-11-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 397002695 | CA | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457601320 | Brandon Rose | Counselor | 314 Nw 5th St Ste 314, Okeechobee, FL 34972-2565 | 2012-09-18 |
| 1275180895 | Brandon Rose | Behavior Technician | 1055 E Colorado Blvd Ste 560, Pasadena, CA 91106-2380 | 2019-08-19 |
| 1548828064 | Brandon Rose | Counselor | 1575 Washington St, Watertown, NY 13601-9371 | 2019-05-30 |
| 1700391604 | Brandon Rose | Social Worker | 5673 Airport Rd, Roanoke, VA 24012-1119 | 2017-12-13 |
| 1255623807 | Brandon Keith Rose | Internal Medicine | 3200 Maccorkle Ave Se Fl 4, Charleston, WV 25304-1227 | 2011-05-13 |
| Street Address |
9207 MAMMATH PEAK CIR |
| City | STOCKTON |
| State | CA |
| Zip Code | 95212-3212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962046524 | Randy Sarnillo Morelos | Residential Treatment Facility, Physical Disabilities | 9152 Chianti Circle, Stockton, CA 95212 | 2019-11-06 |
| 1316494339 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 9555 Priscilla Ln, Stockton, CA 95212 | 2016-09-07 |
| 1487058848 | Faith Isiderio | Physical Therapy Assistant | 5650 Patti Lynn Way, Stockton, CA 95212 | 2014-10-14 |
| 1124173448 | George T Lin | Dentist | 3459 Matterhorn Drive, Stockton, CA 95212 | 2007-01-25 |
| 1851395131 | Eric Chapa | Family Medicine | 5040 E Morada Ln, Stockton, CA 95212 | 2005-06-02 |
| 1114530250 | Heather Elizabeth Phillips | Licensed Psychiatric Technician | 4900 N Highway 99 Unit 68, Stockton, CA 95212-1007 | 2020-08-28 |
| 1396281507 | Kaitlend Tatiana Smith | Behavioral Analyst | 4899 Hildreth Ln, Stockton, CA 95212-1408 | 2017-01-11 |
| 1629489315 | Charles Vansicklen | Student in an Organized Health Care Education/Training Program | 8619 Emanuel Way, Stockton, CA 95212-1423 | 2014-05-15 |
| 1891853826 | Raleys | Pharmacy | 4255 E Morada Ln, Stockton, CA 95212-1600 | 2006-12-04 |
| 1881006351 | Phillip H Shin | Pharmacist | 4255 E Morada Ln, Stockton, CA 95212-1600 | 2014-06-02 |
| Find all providers in zip 95212 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407489966 | Hollywood Rcfe, LLC | Assisted Living Facility | 2306 Hollywood Dr, Stockton, CA 95210-1626 | 2020-02-12 |
| 1316354459 | Good Samaritan Carechoice & Compliance Group LLC | Assisted Living Facility | 5315 Barbados Cir, Stockton, CA 95210-6608 | 2014-07-22 |
| 1477809259 | Mgsact, Inc. | Assisted Living Facility | 517 East Fulton Street, Stockton, CA 95204-2227 | 2012-07-30 |
| 1619114881 | Stockton Heritage Partners, LLC | Assisted Living Facility | 3530 Deer Park Dr, Stockton, CA 95219-2350 | 2009-01-09 |
| 1083899660 | Country Palms Care Home | Assisted Living Facility | 2905 Bristol Ave, Stockton, CA 95204-3935 | 2008-01-02 |
| 1376723973 | Icare Manor, Inc. | Assisted Living Facility | 1215 W Swain Rd, Stockton, CA 95207-4228 | 2007-11-12 |
| 1982803961 | Villa Marche | Assisted Living Facility | 1119 Rose Marie Ln, Stockton, CA 95207 | 2007-07-11 |
| 1023225372 | Tru Health Inc | Assisted Living Facility | 2324 Lever Blvd, Stockton, CA 95206-2900 | 2007-05-17 |
| 1639205925 | Covenant Care, Inc | Assisted Living Facility | 2435 Wagner Heights Rd, Stockton, CA 95209-1778 | 2007-02-23 |
| 1407997281 | Mgsact Inc | Assisted Living Facility | 517 E Fulton St, Stockton, CA 95204 | 2007-02-12 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.