Individual provider Active NPI

Stefan Marc Rosenthal, PSY.D.

  • Marriage & Family Therapist
  • Woodland Hills, CA
National Provider Identifier
1366620908
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
39592 Issued in CA
Practice address
20300 Ventura Blvd Ste 315
Woodland Hills, CA 91364-0903
Phone
(818) 333-6444
NPI assigned
Feb 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 39592 CA Primary

Addresses

Primary practice location

20300 Ventura Blvd Ste 315
Woodland Hills, CA 91364-0903

Mailing address

20300 Ventura Blvd Ste 315
Woodland Hills, CA 91364-0903
Phone (818) 333-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240105001282 CA Practitioner - Marriage and Family Therapist 4082065875 Practice locations: Woodland Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20300 Ventura Blvd
Suite 315
Woodland Hills, CA 91364-0903
Phone (818) 333-6444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39592CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Mimi Shagaga Inc. CurrentSince Jan 28, 2024 Accepting new patients

Locations

20300 Ventura Blvd
Ste 315
Woodland Hills, CA 91364
Phone (310) 569-8328

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1366620908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20300 VENTURA BLVD STE 315",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913640903",
            "telephone_number": "818-333-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20300 VENTURA BLVD STE 315",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913640903",
            "telephone_number": "818-333-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "STEFAN",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2024-01-23",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "39592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

Verify at the official NPI Registry.