IDA M. ROBERTS (NPI# 1922023241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922023241 |
| Entity Type | Individual |
| Full Name | IDA M. ROBERTS |
| Credential | PH.D |
| Practice Address |
433 Callan Ave Ste 203 San Leandro CA 94577-4643 |
| Mailing Address |
1729 Edgehill Rd San Leandro CA 94577-5310 |
| Practice Telephone | 5103572745 |
| Practice Fax Number | 5103572329 |
| Mailing Telephone | 5103572745 |
| Mailing Fax Number | 5103572329 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY16368 | CA | Behavioral Health & Social Service Providers |
| Street Address |
433 CALLAN AVE STE 203 |
| City | SAN LEANDRO |
| State | CA |
| Zip Code | 94577-4643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083093199 | K Whitaker Inc | Counselor | 433 Callan Ave, Ste 209, San Leandro, CA 94577-4643 | 2015-05-21 |
| 1790190866 | Ward Chiropractic | Chiropractor | 433 Callan Ave, Ste 104, San Leandro, CA 94577-4643 | 2014-06-26 |
| 1265681886 | Mariana Cazares | Acupuncturist | 433 Callan Ave, San Leandro, CA 94577-4643 | 2008-09-18 |
| 1528278561 | Nathaniel Van Goodlow | Psychologist | 433 Callan Ave, Suite 307, San Leandro, CA 94577-4643 | 2007-05-22 |
| 1972623858 | Jason Su | Acupuncturist | 433 Callan Ave, Suite 204, San Leandro, CA 94577-4643 | 2007-04-02 |
| 1437276292 | Jooske Annie Stil | Counselor | 433 Callan Ave, Suite 104, San Leandro, CA 94577-4643 | 2007-03-24 |
| 1376614388 | Cynthia Renee Ward | Chiropractor | 433 Callan Ave, Ste. 104, San Leandro, CA 94577-4643 | 2006-11-13 |
| 1285704064 | Juan Jose Lopez | Chiropractor | 433 Callan Ave, Suite 104, San Leandro, CA 94577-4643 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093358574 | A Caring Heart Home Health Inc. | In Home Supportive Care | 215-237 Estudillo Ave, Suite 202, San Leandro, CA 94577 | 2019-10-28 |
| 1871070052 | New Connections Neuropsychology, PC | Clinical Neuropsychologist | 1057 Macarthur Blvd, Ste 214, San Leandro, CA 94577 | 2018-07-20 |
| 1790287266 | Jennifer Capilla | Behavior Technician | 333 Estudillo Ave #204, San Leandro, CA 94577 | 2018-03-01 |
| 1891296760 | Maryann Kruse Bens | Clinical Neuropsychologist | 1057 Macarthur Blvd Ste 214, San Leandro, CA 94577 | 2018-02-26 |
| 1811406721 | Brendon Hoang Nguyen | Dentist | 145 E 14th St, San Leandro, CA 94577 | 2017-09-22 |
| 1801311774 | Calvin Walker | Counselor | 3801 Teagarden Street, San Leandro, CA 94577 | 2017-08-11 |
| 1184154999 | Shauntrinae Mason | Marriage & Family Therapist | 1000 San Leandro Blvd., Suite 300, San Leandro, CA 94577 | 2017-06-14 |
| 1912453135 | Dr. Marshea Evans | Point of Service | 1068 E14th Street, San Leandro, CA 94577 | 2016-08-28 |
| 1902252935 | Mobility Express Medical Transportation | Non-emergency Medical Transport (VAN) | 1695 Abram Ct Ste 202, San Leandro, CA 94577 | 2016-05-09 |
| 1194170381 | Girls Incorporated of Alameda County | Community/Behavioral Health | 2251 Bancroft Ave, San Leandro, CA 94577 | 2016-04-26 |
| Find all providers in zip 94577 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861747552 | Jaseon S. Outlaw | Psychologist | 13847 E 14th St Ste 202, San Leandro, CA 94578-2626 | 2012-07-18 |
| 1831380146 | Mary Marth | Psychologist | 2500 Fairmont Drive, Guidance Clinic, San Leandro, CA 94578 | 2007-08-05 |
| 1982803169 | Kambiz Sakhai | Psychologist | 303 W Joaquin Ave Ste 100, San Leandro, CA 94577-3667 | 2007-07-17 |
| 1457559569 | Wana Shirgul Salehi | Psychologist | 2418 Fairway Dr, San Leandro, CA 94577-5411 | 2007-07-10 |
| 1932304052 | Myron John Gulseth | Psychologist | 13851 East 14th Street, Suite 203, San Leandro, CA 94578 | 2007-06-19 |
| 1114130978 | Erica Wandner | Psychologist | 13666 East 14th St, San Leandro, CA 94578 | 2007-05-08 |
| 1538204847 | Lori Ann Spampinato | Psychologist | 15250 Hesperian Blvd Ste 100, San Leandro, CA 94578-3962 | 2007-02-21 |
| 1649336793 | Rosemarie Ratto | Psychologist | 345 Estudillo Ave Ste 207, San Leandro, CA 94577-4727 | 2006-12-30 |
| 1578633491 | Joanna L Zygmont | Psychologist | 400 Estudillo Ave Ste 201, San Leandro, CA 94577-4900 | 2006-11-08 |
| 1861017097 | Elena Duong | Psychologist | 777 Davis St, San Leandro, CA 94577-6923 | 2020-06-12 |
| Find all providers in SAN LEANDRO | ||||
| City | SAN LEANDRO |
| Zip Code | 94577 |
Please comment or provide details below to improve the information on IDA M. ROBERTS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.