Provider Demographics
NPI:1801437371
Name:HEIDI DAHL-ROSENBAUM, MD, INC.
Entity type:Organization
Organization Name:HEIDI DAHL-ROSENBAUM, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAHL-ROSENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-223-0700
Mailing Address - Street 1:530 W OJAI AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-2472
Mailing Address - Country:US
Mailing Address - Phone:805-223-0700
Mailing Address - Fax:
Practice Address - Street 1:530 W OJAI AVE STE 208
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-2472
Practice Address - Country:US
Practice Address - Phone:805-223-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-04
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty