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NPI Code Detail

MEDICARE: RICK J ROGERS RRW

MEDICARE: RICK J ROGERS RRW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1083955140
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICK J ROGERS RRW
Provider Business Mailing Address
First Line : 1446 ETHAN WAY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95825-2214
Country : US
Telephone Number : 916-922-9217
Fax Number : 916-921-1128
Provider Business Practice Location Address
First Line : 1446 ETHAN WAY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95825-2214
Country : US
Telephone Number : 916-922-9217
Fax Number : 916-921-1128
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2013
Last Update Date : 02/04/2014

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