Active NPI
Terri Lee Roberson
- Clinical Psychologist
- Sonoma, CA
National Provider Identifier
1972079143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 21565
- Practice address
- 19337 Apple Valley Rd
Sonoma, CA 95476-4824 - Phone
- (707) 771-0337
- NPI assigned
- Oct 15, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 21565 | CA | Primary |
Addresses
Primary practice location
19337 Apple Valley Rd
Sonoma, CA 95476-4824
Mailing address
19337 Apple Valley Rd
Sonoma, CA 95476-4824
Phone (707) 771-0337
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21565 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539561600000",
"number": "1972079143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19337 APPLE VALLEY RD",
"city": "SONOMA",
"state": "CA",
"postal_code": "954764824",
"telephone_number": "707-771-0337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19337 APPLE VALLEY RD",
"city": "SONOMA",
"state": "CA",
"postal_code": "954764824",
"telephone_number": "707-771-0337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERSON",
"first_name": "TERRI",
"middle_name": "LEE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-15",
"last_updated": "2018-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "21565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sonoma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.