Provider Demographics
NPI:1578692984
Name:ROSENGREN, MICHAEL MAURITZ (MFT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:MAURITZ
Last Name:ROSENGREN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7070 SCHIRRA CT STE 200
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-2122
Mailing Address - Country:US
Mailing Address - Phone:661-834-7564
Mailing Address - Fax:661-831-8882
Practice Address - Street 1:7070 SCHIRRA CT STE 200
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-2122
Practice Address - Country:US
Practice Address - Phone:661-834-7564
Practice Address - Fax:661-831-8882
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 28696106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist