Individual provider Active NPI

Robyn Wilson, M.A.

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1679968721
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF88270 Issued in CA
Practice address
3322 Chanate Rd
Santa Rosa, CA 95404-1708
Phone
(831) 588-9660
NPI assigned
Apr 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 IMF88270 CA Primary

Addresses

Primary practice location

3322 Chanate Rd
Santa Rosa, CA 95404-1708

Mailing address

330A Bodega Ave
Petaluma, CA 94952-2673
Phone (831) 588-9660

Other practice location 1

1330 Lincoln Ave Ste 201
San Rafael, CA 94901-2142
Phone (831) 588-9660

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 Arts

State licenses

LicenseStateTypeSpecialty
IMF88270CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1428105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679968721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330A BODEGA AVE",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522673",
            "telephone_number": "831-588-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041708",
            "telephone_number": "831-588-9660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 Lincoln Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949012142",
            "country_code": "US",
            "telephone_number": "831-588-9660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROBYN",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF88270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.