Robyn R Takeshita Debary, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

27443 Issued in CA

Practice address

2401 Waterman Blvd Ste A4
Fairfield, CA 94534-1869

Phone

(707) 639-0256

NPI assigned

Jul 21, 2011

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 names 1

• Dr. Robyn R Takeshita Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Robyn T. Debary PSYD., Inc.

  • Clinical Child & Adolescent Psychologist
  • Fairfield, CA
  • NPI 1780052092
  NPD (past) Authorized official

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1942588108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9241 OLD STATE HWY UNIT 483",
            "city": "NEWCASTLE",
            "state": "CA",
            "postal_code": "956581420",
            "telephone_number": "707-639-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 WATERMAN BLVD STE A4",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945341869",
            "telephone_number": "707-639-0256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Melody Ln",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956785167",
            "country_code": "US",
            "telephone_number": "707-639-0256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAKESHITA DEBARY",
        "first_name": "ROBYN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY 1264",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "27443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBYN",
            "last_name": "TAKESHITA",
            "middle_name": "R",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• T-Ja Enterprise LLC
• Marlon Cabahug Taasan, DMD
• Kristel Baquiran Tabzon
• Margaret Conley Tadano, NP
• Tahoe Transit Inc.
• Amandeep Takher, D.M.D.
• Richard Lloyd Talbott, M.S.
• Jela Tallette
• Evan Tam
• Paul Joseph Tambini, LCSW

• Clinical Psychologist in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.