Healthcare Provider Details

I. General information

NPI: 1851436638
Provider Name (Legal Business Name): HEIDI A DAHL-ROSENBAUM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI AVENELLE ROSENBAUM MD

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OUTLET CENTER DR STE 110
OXNARD CA
93036-0608
US

IV. Provider business mailing address

530 W OJAI AVE STE 208
OJAI CA
93023-2472
US

V. Phone/Fax

Practice location:
  • Phone: 805-604-4588
  • Fax:
Mailing address:
  • Phone: 805-223-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA70866
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA70866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: