Healthcare Provider Details

I. General information

NPI: 1275441255
Provider Name (Legal Business Name): BROOKE ROBERTS LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9286 MADISON AVE
ORANGEVALE CA
95662-5857
US

IV. Provider business mailing address

PO BOX 1679
SACRAMENTO CA
95812-1679
US

V. Phone/Fax

Practice location:
  • Phone: 916-365-2012
  • Fax:
Mailing address:
  • Phone: 916-365-2012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM792
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: