Healthcare Provider Details

I. General information

NPI: 1467327833
Provider Name (Legal Business Name): JOCYLEN KYNDEL ROGERS MSW, ACSM
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 S L ST
DINUBA CA
93618-2323
US

IV. Provider business mailing address

144 S L ST
DINUBA CA
93618-2323
US

V. Phone/Fax

Practice location:
  • Phone: 559-591-6680
  • Fax: 855-264-9311
Mailing address:
  • Phone: 559-591-6680
  • Fax: 855-264-9311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW129956
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: