MIRANDA SUSIE ROSE
NPI 1568134476
Licensed Psychiatric Technician in Sacramento, CA

Active since September 29, 2021
4612 ROOSEVELT AVE, SACRAMENTO, CA 95820(916) 379-5876 Get Directions Write a Review

NPPES record last updated: September 29, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Miranda Susie Rose NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIRANDA SUSIE ROSE (NPI 1568134476) is an individual licensed psychiatric technician in Sacramento, California, licensed in California (41809) and active in the NPI registry since September 2021.

NPPES Registry Identity

NPI1568134476
Entity TypeIndividualFemale
Primary Taxonomy167G00000X
Provider Legal NameMIRANDA SUSIE ROSE
Location Address4612 ROOSEVELT AVESacramento, CA 95820-4520
Mailing Address18225 Hale AveMorgan Hill, CA 95037-3547 · (916) 892-6024
Sole ProprietorNo
Enumeration DateSeptember 29, 2021
NPPES CertifiedSeptember 29, 2021
NPI 1568134476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyLicensed Psychiatric TechnicianNursing Service Providers
Taxonomy Code167G00000X
License Licensed in CA · 41809
Definition

An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities.

4612 ROOSEVELT AVE, Sacramento, CA 95820

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Licensed Psychiatric Technician
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Social Worker (Clinical)
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Community Health Worker
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Licensed Vocational Nurse
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Licensed Psychiatric Technician
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Technician, Pathology (Phlebotomy)
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Licensed Psychiatric Technician
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820
Student in an Organized Health Care Education/Training Program
4612 ROOSEVELT AVE
SACRAMENTO, CA 95820

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Miranda Rose's NPI number?

The NPI number for Miranda Rose is 1568134476. It was assigned to this individual provider in the NPPES registry on September 29, 2021.

Where is Miranda Rose located?

Miranda Rose practices at 4612 Roosevelt Ave, Sacramento, CA 95820. The listed phone number is (916) 379-5876.

What is Miranda Rose's specialty?

The primary specialty registered for this NPI is Licensed Psychiatric Technician with taxonomy code 167G00000X.

When was this NPI record last updated?

The NPPES record for Miranda Rose was last updated on September 29, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.