MEDICARE: BERENICE D ROSILLO

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	106H00000X	Marriage & Family Therapist	LMFT88225	CA
2	106H00000X	Marriage & Family Therapist	LMFT15669	AZ

General Provider Information

NPI Number	:	1538400924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERENICE D ROSILLO

Provider Business Mailing Address
First Line	:	16055 VENTURA BLVD STE 605
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-2609
Country	:	US
Telephone Number	:	818-268-8920
Fax Number	:

Provider Business Practice Location Address
First Line	:	16055 VENTURA BLVD STE 605
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-2609
Country	:	US
Telephone Number	:	818-268-8920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2013
Last Update Date	:	03/10/2026

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Directions to “ BERENICE D ROSILLO ” Practice Location

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