Individual provider Active NPI

Roxanne Lauren Eberhardt

  • Marriage & Family Therapist
  • Chico, CA
National Provider Identifier
1043461239
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
51903 Issued in CA
Practice address
1530 Humboldt Rd Ste 4
Chico, CA 95928-9196
Phone
(530) 570-7180
NPI assigned
Oct 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 51903 CA Primary

Addresses

Primary practice location

1530 Humboldt Rd Ste 4
Chico, CA 95928-9196

Mailing address

1530 Humboldt Rd Ste 4
Chico, CA 95928-9196
Phone (530) 570-7180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2024 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
51903CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1043461239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 HUMBOLDT RD STE 4",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959289196",
            "telephone_number": "530-570-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 HUMBOLDT RD STE 4",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959289196",
            "telephone_number": "530-570-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERHARDT",
        "first_name": "ROXANNE",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-06",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "51903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.