Active NPI
Roy Carroll Rawers, M.F.T.
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1760784649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 49058
- Practice address
- 3625 Ruffin Rd
Suite 302
San Diego, CA 92123-1879 - Phone
- (858) 864-8769
- Fax
- (858) 244-1807
- NPI assigned
- Nov 26, 2010
- 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 | 49058 | CA | Primary |
Addresses
Primary practice location
3625 Ruffin Rd
Suite 302
San Diego, CA 92123-1879
Mailing address
3625 Ruffin Rd
Suite 302
San Diego, CA 92123-1879
Phone (858) 864-8769
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 26, 2024 through Oct 26, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49058 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372118400000",
"number": "1760784649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3625 RUFFIN RD",
"address_2": "SUITE 302",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231879",
"telephone_number": "858-864-8769",
"fax_number": "858-244-1807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3625 RUFFIN RD",
"address_2": "SUITE 302",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231879",
"telephone_number": "858-864-8769",
"fax_number": "858-244-1807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAWERS",
"first_name": "ROY",
"middle_name": "CARROLL",
"credential": "M.F.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-11-26",
"last_updated": "2013-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "49058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.