Healthcare Provider Details

I. General information

NPI: 1811107907
Provider Name (Legal Business Name): STEVEN A ROGERS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N ROSE AVE STE 470
OXNARD CA
93030-7659
US

IV. Provider business mailing address

1700 N ROSE AVE STE 470
OXNARD CA
93030-7659
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-2775
  • Fax: 805-278-1220
Mailing address:
  • Phone: 805-988-2775
  • Fax: 805-278-1220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number21463
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number21463
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: