Provider Demographics
NPI:1952529240
Name:ROTHBERG, DEBORAH LIEBER (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LIEBER
Last Name:ROTHBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:LIEBER
Other - Last Name:ROTHBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6200 WILSHIRE BLVD STE 1612
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5817
Mailing Address - Country:US
Mailing Address - Phone:310-991-2989
Mailing Address - Fax:323-857-8008
Practice Address - Street 1:6200 WILSHIRE BLVD STE 1612
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5817
Practice Address - Country:US
Practice Address - Phone:310-991-2989
Practice Address - Fax:323-857-8008
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8074103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical