Provider Demographics
NPI:1518156272
Name:ROSLIN, FRAN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:FRAN
Middle Name:
Last Name:ROSLIN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 VIA LARA
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-6849
Mailing Address - Country:US
Mailing Address - Phone:805-402-1331
Mailing Address - Fax:805-498-4036
Practice Address - Street 1:265 VIA LARA
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-6849
Practice Address - Country:US
Practice Address - Phone:805-402-1331
Practice Address - Fax:805-498-4036
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31176106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist