Provider Demographics
NPI:1427132299
Name:ISLAND, ROSENDO L (LMFT)
Entity type:Individual
Prefix:MR
First Name:ROSENDO
Middle Name:L
Last Name:ISLAND
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:MR
Other - First Name:ROSENDO
Other - Middle Name:L
Other - Last Name:ISLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:3835 N FREEWAY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1954
Mailing Address - Country:US
Mailing Address - Phone:916-576-7900
Mailing Address - Fax:
Practice Address - Street 1:3300 WEBSTER ST STE 804
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3123
Practice Address - Country:US
Practice Address - Phone:855-501-1004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53985106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist