Provider Demographics
NPI:1801680087
Name:RODGERS, ROCELIE M
Entity type:Individual
Prefix:
First Name:ROCELIE
Middle Name:M
Last Name:RODGERS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1043 MCKENNA CT
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95304-5922
Mailing Address - Country:US
Mailing Address - Phone:209-321-5695
Mailing Address - Fax:209-297-4688
Practice Address - Street 1:1043 MCKENNA CT
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95304-5922
Practice Address - Country:US
Practice Address - Phone:209-321-5695
Practice Address - Fax:209-297-4688
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)