Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY 18963 | CA |
Y | 103T00000X | Psychologist | PSY 18963 | CA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY18963 | CA |
NPI | 1285827550 |
---|---|
Provider Name | Dr. Serina Rosenkjar |
First Address | Van Nuys, CA 91401-3624 |
Second Address | Van Nuys, CA 91401-3624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2007 |
Last Update Date | 01/03/2011 |