Ryan Garrett Roback, M.A.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

113205 Issued in CA

Practice address

1529 E Palmdale Blvd Ste 210
Palmdale, CA 93550-2029

Phone

(661) 272-9996

NPI assigned

Oct 5, 2016

Last updated

May 28, 2019By the provider in NPPES

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Soultenders IncGroup PAC ID 6507170453, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Soultenders, Inc.

  • Clinical Psychologist
  • Arcadia, CA
  • NPI 1164617007
  Medicare reassignment Care Compare group NPD
• Soultenders Psychological Services, Inc.

  • Clinical Social Worker
  • Arcadia, CA
  • NPI 1235810722
  NPD
• All for Kids Organization

  • Community/Behavioral Health Agency
  • Palmdale, CA
  • NPI 1609902436
  NPD (past)

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1215487095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 E PALMDALE BLVD STE 210",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935502029",
            "telephone_number": "661-272-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 E PALMDALE BLVD STE 210",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935502029",
            "telephone_number": "661-272-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBACK",
        "first_name": "RYAN",
        "middle_name": "GARRETT",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-05",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "113205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leticia Rivera, LICENSE
• Rocio Rivera
• Sylvia Andrea Rivera
• Ysell Rivera, B.A
• Olga G Rivero
• Nicole Robbins
• T'Azane Imani Louise Roberson
• Robert Haze DDS, Inc. (Valleywide Dental)
• Robert M Jackson, M.D.
• Kay Dee Roberts, PA

• Marriage & Family Therapist in Palmdale, CA
• Providers in Palmdale, 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 May 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.