MEDICARE: ROCKWOOD THERAPY GROUP - A PSYCHOLOGICAL CORPORATION

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
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1235955030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKWOOD THERAPY GROUP - A PSYCHOLOGICAL CORPORATION

Provider Business Mailing Address
First Line	:	1950 W CORPORATE WAY # 10207
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92801-5373
Country	:	US
Telephone Number	:	714-400-2858
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 N EL MOLINO AVE STE 202
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-4404
Country	:	US
Telephone Number	:	714-400-2858
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. TRINNIN OLSEN
Credential	:	PSYD
Telephone Number	:	714-400-2858

Provider Enumeration Date	:	11/26/2024
Last Update Date	:	11/26/2024

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