Provider Demographics
NPI:1073986642
Name:ROSENBERG, CHARLOTTE (CLINICAL PSYCHOLOGIS)
Entity Type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:CLINICAL PSYCHOLOGIS
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:
Other - Last Name:JEVONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CLINICAL PSYCHOLOGIS
Mailing Address - Street 1:2210 I ST
Mailing Address - Street 2:APT 11C
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4070
Mailing Address - Country:US
Mailing Address - Phone:415-745-5093
Mailing Address - Fax:
Practice Address - Street 1:2008 MORSE AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2135
Practice Address - Country:US
Practice Address - Phone:916-973-7323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27571103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical