Healthcare Provider Details

I. General information

NPI: 1073937231
Provider Name (Legal Business Name): TENISHA RODGERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2014
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PIERCE ST
SAN FRANCISCO CA
94115-4005
US

IV. Provider business mailing address

1825 POGGI ST APT 303A
ALAMEDA CA
94501-1871
US

V. Phone/Fax

Practice location:
  • Phone: 415-563-8200
  • Fax:
Mailing address:
  • Phone: 510-520-8245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: