Provider Demographics
NPI:1609896356
Name:RODGERS, BEVERLY J (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:J
Last Name:RODGERS
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 1:44426 10TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3325
Mailing Address - Country:US
Mailing Address - Phone:661-940-0530
Mailing Address - Fax:661-940-0591
Practice Address - Street 1:44426 10TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3325
Practice Address - Country:US
Practice Address - Phone:661-940-0530
Practice Address - Fax:661-940-0591
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32850101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health