Basic Information
| Provider Information | |||||||||
| NPI: | 1679013114 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROOK-DEL ROSARIO | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.S. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | ROOK | ||||||||
| OtherFirstName: | ANNA | ||||||||
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| OtherCredential: | M.S. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5601 DE SOTO AVE FL 5 | ||||||||
| Address2: | |||||||||
| City: | WOODLAND HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913676701 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5601 DE SOTO AVE FL 5 | ||||||||
| Address2: | |||||||||
| City: | WOODLAND HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913676701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8557017955 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2017 | ||||||||
| LastUpdateDate: | 11/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | IMF89320 | CA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 106H00000X | 107511 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.