Provider Demographics
NPI:1346665734
Name:ROSCOE, DARLYNN SHOSHANA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DARLYNN
Middle Name:SHOSHANA
Last Name:ROSCOE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 ARROYO DEL MAR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-5961
Mailing Address - Country:US
Mailing Address - Phone:805-402-8617
Mailing Address - Fax:
Practice Address - Street 1:25 ROLLING OAKS DR STE 208
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1009
Practice Address - Country:US
Practice Address - Phone:805-402-8617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78870106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist