Provider Demographics
NPI:1609807502
Name:ROCKLIN, NEIL FINEGOLD (PHD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:FINEGOLD
Last Name:ROCKLIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21243 VENTURA BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2109
Mailing Address - Country:US
Mailing Address - Phone:818-346-4783
Mailing Address - Fax:
Practice Address - Street 1:21243 VENTURA BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2109
Practice Address - Country:US
Practice Address - Phone:818-346-4783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5027103TA0700X, 103TB0200X, 103TC2200X, 103TE1100X, 103TM1800X, 305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Not Answered305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY5027OtherLICENSE NUMBER