Active NPI
Robert Forrest Roan
- Marriage & Family Therapist
- Mission Hills, CA
National Provider Identifier
1306577291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 101219
- Practice address
- 10200 Sepulveda Blvd Ste 100
Mission Hills, CA 91345-3316 - Phone
- (805) 275-2301
- NPI assigned
- Jun 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 101219 | CA | Primary |
Addresses
Primary practice location
10200 Sepulveda Blvd Ste 100
Mission Hills, CA 91345-3316
Mailing address
1531 Castillo St Apt C
Santa Barbara, CA 93101-8514
Phone (805) 699-6142
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 11, 2026 through Jan 11, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101219 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1306577291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1531 CASTILLO ST APT C",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931018514",
"telephone_number": "805-699-6142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10200 SEPULVEDA BLVD STE 100",
"city": "MISSION HILLS",
"state": "CA",
"postal_code": "913453316",
"telephone_number": "805-275-2301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROAN",
"first_name": "ROBERT",
"middle_name": "FORREST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-21",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "101219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.