Healthcare Provider Details

I. General information

NPI: 1205690484
Provider Name (Legal Business Name): DUNJA RONSBERGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DUNJA RAOUF

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 E SOUTH ST STE 307
LAKEWOOD CA
90805-4598
US

IV. Provider business mailing address

3300 E SOUTH ST STE 307
LAKEWOOD CA
90805-4598
US

V. Phone/Fax

Practice location:
  • Phone: 562-900-0958
  • Fax:
Mailing address:
  • Phone: 562-900-0958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: