Provider Demographics
NPI:1487334256
Name:MARSDEN, ROGER (PHD MFT)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:
Last Name:MARSDEN
Suffix:
Gender:M
Credentials:PHD MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 BANCROFT AVE STE 125B
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2456
Mailing Address - Country:US
Mailing Address - Phone:510-383-1671
Mailing Address - Fax:
Practice Address - Street 1:7200 BANCROFT AVE STE 125B
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2456
Practice Address - Country:US
Practice Address - Phone:510-383-1671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT23493101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health