Provider Demographics
NPI:1619152451
Name:ROSENBERG PHD, SANFORD (PHD)
Entity Type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:
Last Name:ROSENBERG PHD
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 1:2196 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4004
Mailing Address - Country:US
Mailing Address - Phone:415-563-2445
Mailing Address - Fax:415-563-2457
Practice Address - Street 1:2196 UNION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4004
Practice Address - Country:US
Practice Address - Phone:415-563-2445
Practice Address - Fax:415-563-2457
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT7251106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist