Provider Demographics
NPI:1083872287
Name:ROGERS-SOEDER, TARA SHEREE (PHD, MS, RDN)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:SHEREE
Last Name:ROGERS-SOEDER
Suffix:
Gender:F
Credentials:PHD, MS, RDN
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:SHEREE
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10535 HOSPITAL WAY
Mailing Address - Street 2:
Mailing Address - City:MATHER
Mailing Address - State:CA
Mailing Address - Zip Code:95655-4200
Mailing Address - Country:US
Mailing Address - Phone:916-843-9472
Mailing Address - Fax:
Practice Address - Street 1:10535 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655-4200
Practice Address - Country:US
Practice Address - Phone:916-843-9472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-26
Last Update Date:2020-05-11
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2018-03-13
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered