Individual provider Active NPI

Katherine Ann Roberts, M.A., LMFT

  • Marriage & Family Therapist
  • Emeryville, CA
National Provider Identifier
1861709768
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
83481 Issued in CA
Practice address
1480 64TH St Ste 150
Emeryville, CA 94608-2267
Phone
(925) 282-1778
NPI assigned
Sep 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Marriage & Family Therapist 106H00000X 83481 CA Primary

Addresses

Primary practice location

1480 64TH St Ste 150
Emeryville, CA 94608-2267

Mailing address

1480 64TH St Ste 150
Emeryville, CA 94608-2267

Other practice location 1

26081 Mocine Ave
Hayward, CA 94544-2923
Phone (510) 881-5921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240705001718 CA Practitioner - Marriage and Family Therapist 9133663826 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
83481CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Apr 28, 2025 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1861709768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 64TH ST STE 150",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 64TH ST STE 150",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082267",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26081 Mocine Ave",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "CA",
            "postal_code": "945442923",
            "country_code": "US",
            "telephone_number": "510-881-5921",
            "fax_number": "510-881-5925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "M.A., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "83481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emeryville, CA

Sources for this page

Verify at the official NPI Registry.