Robert M Pellerin, PH.D.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 48241 Issued in CA

Practice address

1110 Melody LN
Suite 125
Roseville, CA 95678-5193

Phone

(916) 878-7657

Fax

(916) 771-4404

NPI assigned

Sep 5, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Mr. Robert M Pellerin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1043312374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 MELODY LN",
            "address_2": "SUITE 125",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785193",
            "telephone_number": "916-878-7657",
            "fax_number": "916-771-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 MELODY LN",
            "address_2": "SUITE 125",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785193",
            "telephone_number": "916-878-7657",
            "fax_number": "916-771-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLERIN",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "IMF 44461",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 48241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "PELLERIN",
            "middle_name": "M",
            "prefix": "MR.",
            "credential": "LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Marriage & Family Therapist in Roseville, CA
• Providers in Roseville, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.