Provider Demographics
NPI:1700228814
Name:ROSENTHAL, LEAH H (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:H
Last Name:ROSENTHAL
Suffix:
Gender:F
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:UC BERKELEY CPS TANG CTR
Mailing Address - Street 2:2222 BANCROFT WAY
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94720-1514
Mailing Address - Country:US
Mailing Address - Phone:510-642-9494
Mailing Address - Fax:
Practice Address - Street 1:UC BERKELEY CPS TANG CTR
Practice Address - Street 2:2222 BANCROFT WAY
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94720-1514
Practice Address - Country:US
Practice Address - Phone:510-642-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18036103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling