Healthcare Provider Details

I. General information

NPI: 1487331336
Provider Name (Legal Business Name): KALE ALAN ROESSLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 BUENA VISTA AVE W
SAN FRANCISCO CA
94117-4108
US

IV. Provider business mailing address

5545 SUNVIEW WAY
ANTIOCH CA
94531-8596
US

V. Phone/Fax

Practice location:
  • Phone: 415-967-7058
  • Fax:
Mailing address:
  • Phone: 925-848-1579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: