Tanya Roberts

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20414 Issued in CA

Practice address

404 W Pine St Ste 1
Lodi, CA 95240-2048

Phone

(209) 401-2134

NPI assigned

Feb 21, 2007

Last updated

Jan 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• San Joaquin Behavioral Health Services

  dba San Joaquin County Behavioral Health Services

  • Community/Behavioral Health Agency
  • Stockton, CA
  • NPI 1215028931

  Clinical

  Medicare reassignment NPD
• County of San Joaquin

  dba San Joaquin County Clinic Manteca

  • Multi-Specialty Clinic/Center
  • Manteca, CA
  • NPI 1417407636
  NPD
• San Joaquin County Behavioral Health Services

  dba San Joaquin County MH Services Tracy Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tracy, CA
  • NPI 1306051370
  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1912042375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6025",
            "city": "GALT",
            "state": "CA",
            "postal_code": "956326025",
            "telephone_number": "209-401-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W PINE ST STE 1",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952402048",
            "telephone_number": "209-401-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TANYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "20414",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "20414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10969254",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald A. Ritzman, D.D.S.
• River Fountains of Lodi
• Sarah Marie Rivera
• Fredrick L Rivers
• RMC Marriage and Family Therapy Group Corporation
• David Daniel Robinson, DO
• Poppi Elisa Rodriguez-Webb, D.O.
• Alejandra Rodriguez, PA
• Joseph Anthony Rodriguez, OTR
• Laura Quinonez Rodriguez, LEP

• Clinical Social Worker in Lodi, CA
• Providers in Lodi, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.