Provider Demographics
NPI:1598374977
Name:ROSENTHAL, ALLAN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13351 RIVERSIDE DR # D122
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2542
Mailing Address - Country:US
Mailing Address - Phone:310-625-5762
Mailing Address - Fax:
Practice Address - Street 1:4751 VENTURA CANYON AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2413
Practice Address - Country:US
Practice Address - Phone:310-478-8994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6553106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty