Provider Demographics
NPI:1851420160
Name:ROSENBLUM, LINDA (MSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:ROSENBLUM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15031 VOSE ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2934
Mailing Address - Country:US
Mailing Address - Phone:818-782-5623
Mailing Address - Fax:818-782-5623
Practice Address - Street 1:15031 VOSE ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2934
Practice Address - Country:US
Practice Address - Phone:818-782-5623
Practice Address - Fax:818-782-5623
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS50271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW5207Medicare ID - Type UnspecifiedLCSW LICENSE NUMBER