Healthcare Provider Details

I. General information

NPI: 1578427688
Provider Name (Legal Business Name): ADAR KAMHOLTZ-ROBERTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LILYA KAMHOLTZ-ROBERTS

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5529 MARSHALL ST
OAKLAND CA
94608-2613
US

IV. Provider business mailing address

2118 WARD ST
BERKELEY CA
94705-1016
US

V. Phone/Fax

Practice location:
  • Phone: 847-708-0539
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC21160
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT159584
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: