Individual provider Active NPI

Brianna Marie Roberts

  • Behavior Technician
  • San Diego, CA
National Provider Identifier
1205693371
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
501 W Broadway Ste 800
San Diego, CA 92101-3546
Phone
(877) 418-2978
Fax
(866) 500-2186
NPI assigned
Mar 4, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Addiction (Substance Use Disorder) Counselor 101YA0400X 17330 CA
Personal Emergency Response Attendant 146D00000X
Paramedic 146L00000X
Intermediate Emergency Medical Technician 146M00000X
Basic Emergency Medical Technician 146N00000X
Case Manager/Care Coordinator 171M00000X
Recreation Therapist 225800000X
Recreational Therapist Assistant 226000000X
Religious Nonmedical Practitioner 374K00000X
Behavior Technician 106S00000X CA Primary

Addresses

Primary practice location

501 W Broadway Ste 800
San Diego, CA 92101-3546

Mailing address

350 Fairway Dr Ste 800
Deerfield Beach, FL 33441-1834
Phone (877) 418-2978

Other practice location 1

2049 Skyline Dr
Lemon Grove, CA 91945-4221
Phone (619) 465-7303

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

LicenseStateTypeSpecialty
17330CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1205693371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 FAIRWAY DR STE 800",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411834",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W BROADWAY STE 800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013546",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2049 Skyline Dr",
            "address_purpose": "LOCATION",
            "city": "Lemon Grove",
            "state": "CA",
            "postal_code": "919454221",
            "country_code": "US",
            "telephone_number": "619-465-7303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRIANNA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "17330",
            "primary": false
        },
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "226000000X",
            "taxonomy_group": "",
            "desc": "Recreational Therapist Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374K00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.