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General NPI Number Information
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NPI Number | 1881936656
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Entity Type | Individual
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Provider Name | JUDITH ELISE ROSENBERG LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 03/20/2013
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Provider Practice Location Address
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Address Line | 9933 MACARTHUR BLVD LIFELONG HOWARD DANIEL CLINIC
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City | OAKLAND
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State | CA
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Zip | 94605
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Country | US
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Telephone | 610-981-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 6928 FAIRVIEW DR
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City | EL CERRITO
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State | CA
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Zip | 94530-1830
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Country | US
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Telephone | 510-393-9277
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Fax | 510-260-0117
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS 4551
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License Number State | CA
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