Active NPI
Roberto Ibarra
- Marriage & Family Therapist
- San Jose, CA
National Provider Identifier
1760631691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 97454
- Practice address
- 828 S Bascom Ave Ste 200
San Jose, CA 95128-2600 - Phone
- (669) 529-7750
- NPI assigned
- Sep 16, 2008
- 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 | 97454 | CA | Primary |
Addresses
Primary practice location
828 S Bascom Ave Ste 200
San Jose, CA 95128-2600
Mailing address
183 Cahill Park Dr
San Jose, CA 95126-4850
Phone (408) 797-5777
Other practice location 1
290 Ioof Ave
Gilroy, CA 95020-5204
Phone (408) 846-2100
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 97454 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748304000000",
"number": "1760631691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "183 CAHILL PARK DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951264850",
"telephone_number": "408-797-5777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "828 S BASCOM AVE STE 200",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951282600",
"telephone_number": "669-529-7750"
}
],
"practiceLocations": [
{
"address_1": "290 Ioof Ave",
"address_purpose": "LOCATION",
"city": "Gilroy",
"state": "CA",
"postal_code": "950205204",
"country_code": "US",
"telephone_number": "408-846-2100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IBARRA",
"first_name": "ROBERTO",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-16",
"last_updated": "2025-05-27",
"certification_date": "2025-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "97454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.