Healthcare Provider Details

I. General information

NPI: 1760441661
Provider Name (Legal Business Name): JULIUS M ROGINA PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 RIDGE ST SUITE A
RENO NV
89501-1717
US

IV. Provider business mailing address

427 RIDGE ST SUITE A
RENO NV
89501-1717
US

V. Phone/Fax

Practice location:
  • Phone: 775-324-2000
  • Fax: 775-322-0167
Mailing address:
  • Phone: 775-324-2000
  • Fax: 775-322-0167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY165
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: