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General NPI Number Information
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NPI Number | 1477472298
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Entity Type | Individual
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Provider Name | JACOB STEPHEN ROGERS FNP
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Gender | Male
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 2808 PARK AVE STE C
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City | MERCED
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State | CA
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Zip | 95348-3392
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Country | US
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Telephone | 209-500-3050
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Fax |
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Provider Business Mailing Address
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Address Line | 3293 MARINER CT
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City | ATWATER
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State | CA
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Zip | 95301-2294
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Country | US
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Telephone | 209-325-6975
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 95040110
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License Number State | CA
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