Provider Demographics
NPI:1417065574
Name:ROGERS, CYNTHIA GAIL (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:GAIL
Last Name:ROGERS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 PRIMROSE DR
Mailing Address - Street 2:SUITE#240
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3520
Mailing Address - Country:US
Mailing Address - Phone:916-600-2864
Mailing Address - Fax:916-961-1107
Practice Address - Street 1:5330 PRIMROSE DR
Practice Address - Street 2:SUITE#240
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3520
Practice Address - Country:US
Practice Address - Phone:916-600-2864
Practice Address - Fax:916-961-1107
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36669106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist