| Elizabeth Lee Rosenblatt, Psyd, A Psychological Corporation | |
|
12405 Venice Blvd 124 Los Angeles CA 90066-3803 | |
| (310) 502-1162 | |
| (866) 485-1162 |
| Full Name | Elizabeth Lee Rosenblatt, Psyd, A Psychological Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 12405 Venice Blvd, Los Angeles, California |
| Authorized Official Name and Position | Elizabeth Lee Rosenblatt (OWNER) |
| Authorized Official Contact | 3105021162 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Lee Rosenblatt, Psyd, A Psychological Corporation 12405 Venice Blvd 124 Los Angeles CA 90066-3803 Ph: (310) 502-1162 | Elizabeth Lee Rosenblatt, Psyd, A Psychological Corporation 12405 Venice Blvd 124 Los Angeles CA 90066-3803 Ph: (310) 502-1162 |
| NPI Number | 1053618314 |
|---|---|
| Provider Enumeration Date | 02/23/2011 |
| Last Update Date | 02/23/2011 |
| Medicare PECOS PAC ID | 0840461562 |
|---|---|
| Medicare Enrollment ID | O20110928000775 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053618314 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY21110 (California) | Primary |
| Provider Name | Elizabeth Rosenblatt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598899510 PECOS PAC ID: 5799877791 Enrollment ID: I20070822001012 |
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