Provider Demographics
NPI:1477045482
Name:MACGREGOR, CASEY ROAGAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:ROAGAN
Last Name:MACGREGOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 AMBERWOOD DR APT 11
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-1911
Mailing Address - Country:US
Mailing Address - Phone:917-969-3009
Mailing Address - Fax:
Practice Address - Street 1:850 COLORADO BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1733
Practice Address - Country:US
Practice Address - Phone:626-657-8543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker