Healthcare Provider Details

I. General information

NPI: 1700739869
Provider Name (Legal Business Name): TIMOTHY ROGERS LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2026
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S FARRELL DR STE B210
PALM SPRINGS CA
92262-7933
US

IV. Provider business mailing address

PO BOX 127
PALM SPRINGS CA
92263-0127
US

V. Phone/Fax

Practice location:
  • Phone: 760-620-5554
  • Fax:
Mailing address:
  • Phone: 951-468-0303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number161433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: