Provider Demographics
NPI:1366620908
Name:ROSENTHAL, STEFAN MARC (PSYD)
Entity type:Individual
Prefix:DR
First Name:STEFAN
Middle Name:MARC
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20300 VENTURA BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-0903
Mailing Address - Country:US
Mailing Address - Phone:818-333-4444
Mailing Address - Fax:
Practice Address - Street 1:20300 VENTURA BLVD STE 315
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-0903
Practice Address - Country:US
Practice Address - Phone:818-333-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39592106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist