Provider Demographics
NPI:1154416634
Name:ROSEN, CRAIG STEVEN (PHD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:STEVEN
Last Name:ROSEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 WILLOW ROAD
Mailing Address - Street 2:VAPAHCS (334-PTSD)
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025
Mailing Address - Country:US
Mailing Address - Phone:650-493-5000
Mailing Address - Fax:650-617-2684
Practice Address - Street 1:795 WILLOW ROAD
Practice Address - Street 2:VAPAHCS (334-PTSD)
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:650-617-2684
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16786103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical