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NPI Code Detail

MEDICARE: MRS. ELIZABETH MARICELLA ROHSKOTHEN MFT

MEDICARE: MRS. ELIZABETH MARICELLA ROHSKOTHEN MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist52345CA

General Provider Information

NPI Number : 1235315953
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH MARICELLA ROHSKOTHEN MFT
Provider Business Mailing Address
First Line : 5330 SAN BERNARDINO ST
Second Line :
City : MONTCLAIR
State : CA
Zip : 91763-2952
Country : US
Telephone Number : 866-205-3595
Fax Number :
Provider Business Practice Location Address
First Line : 5330 SAN BERNARDINO ST
Second Line :
City : MONTCLAIR
State : CA
Zip : 91763-2952
Country : US
Telephone Number : 866-205-3595
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2008
Last Update Date : 11/16/2021

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