Provider Demographics
NPI:1073937231
Name:RODGERS, TENISHA
Entity Type:Individual
Prefix:
First Name:TENISHA
Middle Name:
Last Name:RODGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 POGGI ST APT 303A
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-1871
Mailing Address - Country:US
Mailing Address - Phone:510-520-8245
Mailing Address - Fax:
Practice Address - Street 1:1301 PIERCE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-4005
Practice Address - Country:US
Practice Address - Phone:415-563-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-08
Last Update Date:2014-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor