Provider Demographics
NPI:1740673144
Name:ROOZEBOOM, WILLIAM (PHD, AMFT)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:ROOZEBOOM
Suffix:
Gender:M
Credentials:PHD, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 HAVEN AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8551
Mailing Address - Country:US
Mailing Address - Phone:909-257-8461
Mailing Address - Fax:
Practice Address - Street 1:9220 HAVEN AVE STE 240
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-8551
Practice Address - Country:US
Practice Address - Phone:909-257-8461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral