Active NPI
Jennifer Ann Rogers, LMT
- Behavior Technician
- Oakland, CA
National Provider Identifier
1043757172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 180 Grand Ave Suite 225
Oakland, CA 94612-8204 - Phone
- (510) 506-7910
- NPI assigned
- Jan 26, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60609992 | WA | |
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
180 Grand Ave Suite 225
Oakland, CA 94612-8204
Mailing address
2730 Shadelands Dr Building 10
Walnut Creek, CA 94598
Other practice location 1
7604 NE 5th Ave
Suite 109
Vancouver, WA 98665-8204
Phone (360) 314-4380
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60609992 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543276800000",
"number": "1043757172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2730 SHADELANDS DR BUILDING 10",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "94598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 GRAND AVE SUITE 225",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946128204",
"telephone_number": "510-506-7910"
}
],
"practiceLocations": [
{
"address_1": "7604 NE 5th Ave",
"address_2": "Suite 109",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986658204",
"country_code": "US",
"telephone_number": "360-314-4380",
"fax_number": "360-314-4390",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROGERS",
"first_name": "JENNIFER",
"middle_name": "ANN",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-26",
"last_updated": "2018-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60609992",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.