Provider Demographics
NPI:1558660019
Name:TOREN, ROSALIE E (PHD)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:E
Last Name:TOREN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2427 BENJAMIN DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-2709
Mailing Address - Country:US
Mailing Address - Phone:650-833-8834
Mailing Address - Fax:
Practice Address - Street 1:2427 BENJAMIN DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-2709
Practice Address - Country:US
Practice Address - Phone:650-833-8834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21581103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist