Alicia Roberts

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

34125 Issued in CA

Practice address

1368 Lincoln Ave
106
San Rafael, CA 94901

Phone

(415) 578-5524

NPI assigned

Nov 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Alicia Willoughby Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Agile Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Palo Alto, CA
  • NPI 1659445443
  NPD (past)
• San Francisco Sport & Spine Physical Therapy

  • Physical Therapist
  • San Francisco, CA
  • NPI 1508945833
  NPD (past)

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1902085236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6041",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "94903",
            "telephone_number": "415-578-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1368 LINCOLN AVE",
            "address_2": "106",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "94901",
            "telephone_number": "415-578-5524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Mitchell Blvd",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949032007",
            "country_code": "US",
            "telephone_number": "415-924-5700",
            "fax_number": "415-924-5723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ALICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-02",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "34125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "WILLOUGHBY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joan Campbell Roane, MFT
• Lisa Marie Robechek, M.DIV.
• Robert B Levine OD a Professional Optometric Corporation
• Roberta Seifert PHD a Psychological Corporation
• Jenene Marie Roberto
• Eric Scott Roberts, BA
• Miles Roberts
• Michael Robins
• Brian Gregory Robinson, PSYD
• Gabriel Robinson

• Physical Therapist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.