Individual
RAPHAEL D. ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
11022 SANTA MONICA BLVD STE 250, LOS ANGELES, CA 90025-7573
(310) 882-8697
Mailing address
11022 SANTA MONICA BLVD STE 250, LOS ANGELES, CA 90025-7573
(310) 882-8697
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
21412
CA
103TC0700X
Clinical Psychologist
21412
CA
Other
Enumeration date
02/10/2009
Last updated
03/17/2018
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