Provider Demographics
NPI:1992743413
Name:ROGERS, JULIA L (PSYD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:L
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:901 NEVIN AVE
Mailing Address - Street 2:KAISER DEPARTMENT OF PSYCHIATRY
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94801-3143
Mailing Address - Country:US
Mailing Address - Phone:510-307-1656
Mailing Address - Fax:510-307-1615
Practice Address - Street 1:901 NEVIN AVE
Practice Address - Street 2:KAISER DEPARTMENT OF PSYCHIATRY
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-3143
Practice Address - Country:US
Practice Address - Phone:510-307-1656
Practice Address - Fax:510-307-1615
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19578103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL195780Medicare ID - Type Unspecified