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General NPI Number Information
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NPI Number | 1700188943
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Entity Type | Individual
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Provider Name | JUDITH SARA ROSENBLATT
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Gender | Female
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Dates
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Enumeration Date | 11/20/2010
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Last Update Date | 05/31/2018
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Provider Practice Location Address
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Address Line | 51 MARINA BLVD
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City | PITTSBURG
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State | CA
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Zip | 94565
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Country | US
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Telephone | 510-406-2578
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Fax |
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Provider Business Mailing Address
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Address Line | 51 MARINA BLVD
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City | PITTSBURG
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State | CA
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Zip | 94565-2068
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Country | US
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Telephone | 510-406-2578
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW60489
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 081869-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 65073
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License Number State | CA
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