Robert Jerome Holmberg II, M.S. COUNSELING

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMF59123 Issued in CA

Practice address

555 Northgate Dr
Family Service Agency of Marin
San Rafael, CA 94903-3680

Phone

(415) 491-5700

NPI assigned

Aug 5, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249430400000",
    "number": "1114158300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 MORNINGSIDE DR",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601431",
            "telephone_number": "562-458-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 NORTHGATE DR",
            "address_2": "FAMILY SERVICE AGENCY OF MARIN",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033680",
            "telephone_number": "415-491-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMBERG",
        "first_name": "ROBERT",
        "middle_name": "JEROME",
        "name_suffix": "II",
        "credential": "M.S. COUNSELING",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-05",
        "last_updated": "2009-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF59123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew John Holland
• Carol Dutton Hollenberg, MFT
• Peter L Holleran, D.C.
• Annette Holloway, PSY.D.
• Ruth A. Holly, MD
• Andre Holmes
• Ruby Lihong Holve-Hensill
• Christine Hom, PH.D.
• Fred B Hom, MD
• Home Helpers Home Care

• Mental Health Counselor in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; 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.