Healthcare Provider Details

I. General information

NPI: 1992861082
Provider Name (Legal Business Name): ROGER SAVAGE DUKE LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2006
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 SANGUINETTI RD UNIT B #196
SONORA CA
95370-6210
US

IV. Provider business mailing address

1311 SANGUINETTI RD UNIT B #196
SONORA CA
95370-6210
US

V. Phone/Fax

Practice location:
  • Phone: 209-499-9189
  • Fax: 209-536-4804
Mailing address:
  • Phone: 209-499-9189
  • Fax: 209-536-4804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC36504
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: