Healthcare Provider Details

I. General information

NPI: 1215045703
Provider Name (Legal Business Name): BRIGITTE ELISABETH RODGERS M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4713 1ST ST 242
PLEASANTON CA
94566-7361
US

IV. Provider business mailing address

535 ROLLING HILLS LN
DANVILLE CA
94526-6227
US

V. Phone/Fax

Practice location:
  • Phone: 925-846-4829
  • Fax: 925-855-9208
Mailing address:
  • Phone: 925-855-5506
  • Fax: 925-855-9208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4639
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: