Individual
KELSEY ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 ILENE STREET, MARTINEZ, CA 94553
(510) 337-7950
Mailing address
1250 WALKER AVE APT 33, WALNUT CREEK, CA 94596-4827
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 35741
CA
Other
Enumeration date
04/04/2014
Last updated
04/04/2014
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