Debra Ann Robertson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

30593 Issued in CA

Practice address

1 Main St
San Quentin, CA 94964-1000

Phone

(415) 454-1460

NPI assigned

May 10, 2018

Last updated

Jan 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Debra Ann Lanham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Corrections and Rehabilitation-Headquarters

  dba Neumiller Infirmary Pharmacy

  • Pharmacy
  • San Quentin, CA
  • NPI 1922308642
  NPD

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1306336888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 SPRINGBROOK RD",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945973918",
            "telephone_number": "415-819-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAIN ST",
            "city": "SAN QUENTIN",
            "state": "CA",
            "postal_code": "949641000",
            "telephone_number": "415-454-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-10",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "LANHAM",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Theresa Mariko Obrero, LCSW
• Kathy Ortiz-Cobian, PH.D
• Kim Marie Parker, MSW
• Haiyan Ramirez Batlle, M.D.
• Gabriela Rivas
• Michael B. Rowe, M.D.
• Linda Rusak, LCSW
• Lauren Maxine Saal-Dalma
• Arya Shah, MD
• Evelyn G Spricktovar, PHD

• Clinical Psychologist in San Quentin, CA
• Providers in San Quentin, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.