Healthcare Provider Details

I. General information

NPI: 1508759069
Provider Name (Legal Business Name): ALISON ROGGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 S EL CAMINO REAL
SAN MATEO CA
94402-2804
US

IV. Provider business mailing address

401 29TH AVE
SAN MATEO CA
94403-2703
US

V. Phone/Fax

Practice location:
  • Phone: 650-458-0026
  • Fax:
Mailing address:
  • Phone: 650-759-9155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: