Jim Rogers

Individual provider Active NPI Marriage & Family Therapist · Helendale, CA

NPI 1669693289 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1669693289
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFT35622 (CA)
Practice address
26734 Jordan Rd.
Suite a-4
Helendale, CA 92342-1484
Phone
(760) 961-6118
Fax
(760) 955-2242
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MFT35622CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT35622 CA Yes

Addresses

Primary practice location

26734 Jordan Rd.
Suite a-4
Helendale, CA 92342-1484

Mailing address

P.O. Box 1484
Helendale, CA 92342-1484

Other providers in Helendale, CA

All providers in Helendale, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.