Healthcare Provider Details

I. General information

NPI: 1942161567
Provider Name (Legal Business Name): DANA ROBERTS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2025
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 E BARSTOW AVE APT 4304 APT 4304
FRESNO CA
93710-8374
US

IV. Provider business mailing address

335 E BARSTOW AVE APT 4304
FRESNO CA
93710-8374
US

V. Phone/Fax

Practice location:
  • Phone: 209-452-8996
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: