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General NPI Number Information
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NPI Number | 1073872362
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Entity Type | Individual
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Provider Name | EMERALD ANNE BERMUDEZ ROGERS LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/08/2012
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 2100 5TH ST
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City | DAVIS
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State | CA
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Zip | 95618-6591
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Country | US
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Telephone | 530-747-3414
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Fax |
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Provider Business Mailing Address
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Address Line | 4346 ALDERWOOD WAY
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City | SACRAMENTO
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State | CA
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Zip | 95864-0807
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Country | US
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Telephone | 916-572-3277
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 96682
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License Number State | CA
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