Individual provider Active NPI

Gary B. Robertson, M.S., LMFT

  • Marriage & Family Therapist
  • La Jolla, CA
National Provider Identifier
1295883619
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 39996 Issued in CA
Practice address
9404 Genesee Ave
Suite 335
La Jolla, CA 92037-1339
Phone
(858) 755-9996
Fax
(858) 587-1142
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 39996 CA Primary

Addresses

Primary practice location

9404 Genesee Ave
Suite 335
La Jolla, CA 92037-1339

Mailing address

9404 Genesee Ave
Suite 335
La Jolla, CA 92037-1339
Phone (858) 755-9996

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MFC 39996CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295883619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9404 GENESEE AVE",
            "address_2": "SUITE 335",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371339",
            "telephone_number": "858-755-9996",
            "fax_number": "858-587-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9404 GENESEE AVE",
            "address_2": "SUITE 335",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371339",
            "telephone_number": "858-755-9996",
            "fax_number": "858-587-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "GARY",
        "middle_name": "B.",
        "credential": "M.S., LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 39996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.