Active NPI
James Paul Roehrig, PH.D.
- Counseling Psychologist
- San Rafael, CA
National Provider Identifier
1932653235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 28360
- Practice address
- 111 Smith Ranch Rd
San Rafael, CA 94903-1939 - Phone
- (415) 491-3013
- NPI assigned
- Aug 4, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 28360 | CA | Primary |
Addresses
Primary practice location
111 Smith Ranch Rd
San Rafael, CA 94903-1939
Mailing address
111 Smith Ranch Rd
San Rafael, CA 94903-1939
Phone (415) 491-3013
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28360 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| California Psychology Center | Past | Accepting new patients |
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.
-
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- Mountain View, CA
- NPI 1508509829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470268800000",
"number": "1932653235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 SMITH RANCH RD",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949031939",
"telephone_number": "415-491-3013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 SMITH RANCH RD",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949031939",
"telephone_number": "415-491-3013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROEHRIG",
"first_name": "JAMES",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-04",
"last_updated": "2016-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "28360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.