Provider Demographics
NPI:1962562330
Name:ROHRER, STACEY JEAN (PHD)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:JEAN
Last Name:ROHRER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 FAIR OAKS BLVD # 14
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4708
Mailing Address - Country:US
Mailing Address - Phone:916-480-6862
Mailing Address - Fax:916-480-6844
Practice Address - Street 1:2345 FAIR OAKS BLVD # 14
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4708
Practice Address - Country:US
Practice Address - Phone:916-480-6862
Practice Address - Fax:916-480-6844
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 20413103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist