Active NPI
Holly Roth, PH.D.
- Psychologist
- Truckee, CA
National Provider Identifier
1760552178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY 16828
- Practice address
- 10059 Palisades Dr Ste 4
Truckee, CA 96161-1945 - Phone
- (530) 582-8822
- Fax
- (530) 582-5474
- NPI assigned
- Nov 9, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY 16828 | CA | Primary |
Addresses
Primary practice location
10059 Palisades Dr Ste 4
Truckee, CA 96161-1945
Mailing address
10150 Klondike Flat Rd
Truckee, CA 96161-2831
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 16828 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760552178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10150 KLONDIKE FLAT RD",
"city": "TRUCKEE",
"state": "CA",
"postal_code": "961612831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10059 PALISADES DR STE 4",
"city": "TRUCKEE",
"state": "CA",
"postal_code": "961611945",
"telephone_number": "530-582-8822",
"fax_number": "530-582-5474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "HOLLY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 16828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Truckee, 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.