Active NPI
Jessica Alyce Bennett-Roberts, B.A.S.W
- Adult Companion
- Fairfield, CA
National Provider Identifier
1235979519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- Practice address
- 2420 Martin Rd Ste 200
Fairfield, CA 94534-8610 - Phone
- (707) 770-9987
- NPI assigned
- May 25, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Adult Companion | 372600000X | CA | Primary | |
| Counselor | 101Y00000X | |||
| Community Health Worker | 172V00000X | |||
| Rehabilitation Practitioner | 225400000X |
Addresses
Primary practice location
2420 Martin Rd Ste 200
Fairfield, CA 94534-8610
Mailing address
2420 Martin Rd Ste 200
Fairfield, CA 94534-8610
Phone (707) 770-9987
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760832000000",
"number": "1235979519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2420 MARTIN RD STE 200",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945348610",
"telephone_number": "707-770-9987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2420 MARTIN RD STE 200",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945348610",
"telephone_number": "707-770-9987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT-ROBERTS",
"first_name": "JESSICA",
"middle_name": "ALYCE",
"credential": "B.A.S.W",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-25",
"last_updated": "2025-10-19",
"certification_date": "2025-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "CA",
"license": null,
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.