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General NPI Number Information
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NPI Number | 1295627396
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Entity Type | Individual
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Provider Name | DAVID WAYNE ROGERS JR.
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Gender |
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 3945 CASTRO VALLEY BLVD SPC 10
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-6048
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Country | US
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Telephone | 341-233-5690
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Fax | 341-233-5690
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Provider Business Mailing Address
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Address Line | 3945 CASTRO VALLEY BLVD SPC 10
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-6048
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Country | US
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Telephone | 341-233-5690
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Fax | 341-233-5690
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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