Basic Information
| Provider Information | |||||||||
| NPI: | 1952954653 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROGERS | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | STEVEN | ||||||||
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| Credential: | MSW, ACSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3801 3RD ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941241409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4086777987 | ||||||||
| FaxNumber: | 4156647094 | ||||||||
| Practice Location | |||||||||
| Address1: | 3801 3RD ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941241409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4086777987 | ||||||||
| FaxNumber: | 4156647094 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2019 | ||||||||
| LastUpdateDate: | 10/28/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | CA | N | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | 111513 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | 111513 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.