Provider Demographics
NPI:1679966493
Name:ROSENBERG, ANGELA (LMFT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 ENCINITAS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3773
Mailing Address - Country:US
Mailing Address - Phone:323-682-0451
Mailing Address - Fax:
Practice Address - Street 1:531 ENCINITAS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3773
Practice Address - Country:US
Practice Address - Phone:323-682-0451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94562106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist