Provider Demographics
NPI:1790027225
Name:JOSEPH ROSNER PH.D. A PSYCHOLOGICAL CORPORATION
Entity type:Organization
Organization Name:JOSEPH ROSNER PH.D. A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSNER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-477-3200
Mailing Address - Street 1:578 LORNA LN
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-4215
Mailing Address - Country:US
Mailing Address - Phone:310-476-8004
Mailing Address - Fax:310-476-6376
Practice Address - Street 1:578 LORNA LN
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-4215
Practice Address - Country:US
Practice Address - Phone:310-476-8004
Practice Address - Fax:310-476-6376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY2430103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP2430OtherPTAN