Provider Demographics
NPI:1023343480
Name:FERRICK ROSENBLATT, KATHLEEN (LAC, PHD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:FERRICK ROSENBLATT
Suffix:
Gender:F
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:FERRICK
Other - Last Name:ROSENBLATT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10415 RAVENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-2517
Mailing Address - Country:US
Mailing Address - Phone:310-470-4557
Mailing Address - Fax:310-470-4557
Practice Address - Street 1:8631 W 3RD ST
Practice Address - Street 2:CEDARS-SINAI 920 EAST TOWER
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5901
Practice Address - Country:US
Practice Address - Phone:310-470-4557
Practice Address - Fax:310-470-4557
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 380171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist