Provider Demographics
NPI:1669675971
Name:ROSENBERG, HILLA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HILLA
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16550 VENTURA BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2004
Mailing Address - Country:US
Mailing Address - Phone:818-754-4441
Mailing Address - Fax:818-223-9851
Practice Address - Street 1:16550 VENTURA BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2004
Practice Address - Country:US
Practice Address - Phone:818-754-4441
Practice Address - Fax:818-223-9851
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPS2006041101Y00000X
CAPSY23527103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY23527OtherCLINICAL PSYCHOLOGIST
CARPS2006041OtherREGISTERED PSYCHOLOGIST