Healthcare Provider Details

I. General information

NPI: 1295160729
Provider Name (Legal Business Name): STACIE ROSENFELD PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2339 AMBERLY PL
SIMI VALLEY CA
93065-2511
US

IV. Provider business mailing address

2339 AMBERLY PL
SIMI VALLEY CA
93065-2511
US

V. Phone/Fax

Practice location:
  • Phone: 818-523-0418
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310589
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: