Provider Demographics
NPI:1447132022
Name:ROSENTHAL, CHAANA MAURI
Entity type:Individual
Prefix:
First Name:CHAANA
Middle Name:MAURI
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13650 MARINA POINTE DR UNIT 1206
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-9291
Mailing Address - Country:US
Mailing Address - Phone:619-957-3192
Mailing Address - Fax:
Practice Address - Street 1:13650 MARINA POINTE DR UNIT 1206
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-9291
Practice Address - Country:US
Practice Address - Phone:619-957-3192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA840904163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN1003XNursing Service ProvidersRegistered NurseNutrition Support