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General NPI Number Information
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NPI Number | 1114676616
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Entity Type | Organization
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Legal Business Name | JULIA ROSENGREN PSYCHOLOGIST, INC.
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 5252 BALBOA AVE STE 803
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City | SAN DIEGO
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State | CA
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Zip | 92117-6920
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Country | US
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Telephone | 858-432-3919
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Fax | 833-439-5561
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Provider Business Mailing Address
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Address Line | 5252 BALBOA AVE STE 803
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City | SAN DIEGO
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State | CA
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Zip | 92117-6920
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Country | US
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Telephone | 858-432-3919
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Fax | 833-439-5561
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Authorized Official
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Title or Position | CEO
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Name | DR. JULIA ROSENGREN
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Credential | PSY.D.
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Telephone | 858-432-3919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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