Provider Demographics
NPI:1780741967
Name:COGER, ROGER WILLIAM (PHD)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:WILLIAM
Last Name:COGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 ERRINGER ROAD
Mailing Address - Street 2:SUITE 217
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-2252
Mailing Address - Country:US
Mailing Address - Phone:805-526-4444
Mailing Address - Fax:805-526-4446
Practice Address - Street 1:2345 ERRINGER RD
Practice Address - Street 2:SUITE 217
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-2235
Practice Address - Country:US
Practice Address - Phone:805-526-4444
Practice Address - Fax:805-526-4446
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7966103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP7966Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID
CA282971Medicare UPIN