Provider Demographics
NPI:1346471588
Name:ROGERS, PAULETTE A (PH D)
Entity Type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:A
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14080 PALM DR
Mailing Address - Street 2:SUITE D-112
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-6851
Mailing Address - Country:US
Mailing Address - Phone:415-317-5718
Mailing Address - Fax:
Practice Address - Street 1:41750 RANCHO LAS PALMAS DR
Practice Address - Street 2:STE L-6, DESERT COUNSELING & ASSESSMENT CENTER-AGUA BL
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-5511
Practice Address - Country:US
Practice Address - Phone:415-317-5718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15653103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist