Active NPI
Eric Scott Roberts, BA
- Counselor
- San Rafael, CA
National Provider Identifier
1972688927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 914 Mission Ave
3Rd Floor
San Rafael, CA 94901-6106 - Phone
- (415) 457-6964
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
914 Mission Ave
3Rd Floor
San Rafael, CA 94901-6106
Mailing address
621 Hillsborough St
Oakland, CA 94606-1009
Phone (510) 927-8314
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
- Credentials
- Bachelor of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Buckelew Programs | 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.
-
- Exclusive Provider Organization
- San Rafael, CA
- NPI 1770783193
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249776000000",
"number": "1972688927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 HILLSBOROUGH ST",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946061009",
"telephone_number": "510-927-8314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "914 MISSION AVE",
"address_2": "3RD FLOOR",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949016106",
"telephone_number": "415-457-6964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "ERIC",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "BA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2009-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"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 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.