Provider Demographics
NPI:1285982116
Name:ROGERS, CLIFTON ERNEST (ASW 31742)
Entity type:Individual
Prefix:
First Name:CLIFTON
Middle Name:ERNEST
Last Name:ROGERS
Suffix:
Gender:M
Credentials:ASW 31742
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 CAMPUS DR.
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097
Mailing Address - Country:US
Mailing Address - Phone:530-841-4800
Mailing Address - Fax:530-841-4299
Practice Address - Street 1:2060 CAMPUS DR.
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097
Practice Address - Country:US
Practice Address - Phone:530-841-4800
Practice Address - Fax:530-841-4299
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor