Provider Demographics
NPI:1922400423
Name:ROSSELLO, ERIN (MA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:ROSSELLO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1949 1/2 WESTWOOD BLVD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-8414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1949 1/2 WESTWOOD BLVD
Practice Address - Street 2:SUITE 7
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-8414
Practice Address - Country:US
Practice Address - Phone:310-625-7155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent