Provider Demographics
NPI:1740141340
Name:ROSARIO, JONATHAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:ROSARIO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 WARWICK WAY UNIT A
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53406-5661
Mailing Address - Country:US
Mailing Address - Phone:262-977-9290
Mailing Address - Fax:
Practice Address - Street 1:1143 WARWICK WAY UNIT A
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-5661
Practice Address - Country:US
Practice Address - Phone:262-977-9290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-21
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program