Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY16735 | CA |
N | 103TC0700X | Clinical Psychologist | PSY16735 | CA |
N | 103TC1900X | Counseling Psychologist | PSY16735 | CA |
N | 103TF0200X | Forensic Psychologist | PSY16735 | CA |
NPI | 1043262504 |
---|---|
Provider Name | Emily Rosten |
First Address | Sacramento, CA 95814-6414 |
Second Address | Atascadero, CA 93423-7001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PSYCH | (02) |