Provider Demographics
NPI:1487331336
Name:ROESSLER, KALE ALAN
Entity type:Individual
Prefix:
First Name:KALE
Middle Name:ALAN
Last Name:ROESSLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5545 SUNVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8596
Mailing Address - Country:US
Mailing Address - Phone:925-848-1579
Mailing Address - Fax:
Practice Address - Street 1:5545 SUNVIEW WAY
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8596
Practice Address - Country:US
Practice Address - Phone:925-848-1579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)