Active NPI
Deborah Corinne Roberts, LCSW
- Social Worker
- Rancho Cordova, CA
National Provider Identifier
1063896090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 4049 Big Meadow Way
Rancho Cordova, CA 95742-7740 - Phone
- (916) 956-4425
- NPI assigned
- Jul 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LCSW24999 | CA | |
| Clinical Social Worker | 1041C0700X | 24999 | CA | |
| Clinical Social Worker | 1041C0700X | LCSW24999 | CA | |
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
4049 Big Meadow Way
Rancho Cordova, CA 95742-7740
Mailing address
10850 Gold Center Dr Ste 325
Rancho Cordova, CA 95670-6177
Phone (916) 364-8395
Other practice location 1
9590 Roan Fields Pl
Elk Grove, CA 95624-6064
Phone (916) 956-4425
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCSW24999 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW24999 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1063896090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10850 GOLD CENTER DR STE 325",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "956706177",
"telephone_number": "916-364-8395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4049 BIG MEADOW WAY",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "957427740",
"telephone_number": "916-956-4425"
}
],
"practiceLocations": [
{
"address_1": "9590 Roan Fields Pl",
"address_purpose": "LOCATION",
"city": "Elk Grove",
"state": "CA",
"postal_code": "956246064",
"country_code": "US",
"telephone_number": "916-956-4425",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBERTS",
"first_name": "DEBORAH",
"middle_name": "CORINNE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-20",
"last_updated": "2024-02-05",
"certification_date": "2024-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "LCSW24999",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "24999",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW24999",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LCSW24999",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cordova, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.