Provider Demographics
NPI:1407954597
Name:ROTHSTEIN, STEVEN (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:ROTHSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:ROTHSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:2021 SPERRY AVE STE 24
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7472
Mailing Address - Country:US
Mailing Address - Phone:909-872-1407
Mailing Address - Fax:
Practice Address - Street 1:2021 SPERRY AVE STE 24
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:909-872-1407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19945103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist