Individual
JILL ERIN ROTHBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3333 CHANATE RD, SANTA ROSA, CA 95404-1707
(707) 565-4919
Mailing address
3333 CHANATE RD, SANTA ROSA, CA 95404-1707
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A069666
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000004900
—
CA
Enumeration date
01/04/2007
Last updated
08/18/2014
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