Healthcare Provider Details

I. General information

NPI: 1235365362
Provider Name (Legal Business Name): JOSEPH N ROSCOE LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSEPH N ROTHFARB LCSW

II. Dates (important events)

Enumeration Date: 06/03/2009
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 N WIGET LN BLDG 2
WALNUT CREEK CA
94598-2408
US

IV. Provider business mailing address

PO BOX 612
ALAMO CA
94507-0612
US

V. Phone/Fax

Practice location:
  • Phone: 925-266-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: