Healthcare Provider Details

I. General information

NPI: 1922924844
Provider Name (Legal Business Name): ROBERTS FAMILY DEVELOPMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 DARINA AVE
SACRAMENTO CA
95815-3120
US

IV. Provider business mailing address

770 DARINA AVE
SACRAMENTO CA
95815-3120
US

V. Phone/Fax

Practice location:
  • Phone: 916-646-6631
  • Fax:
Mailing address:
  • Phone: 916-646-6631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DERRELL ROBERTS
Title or Position: CEO
Credential:
Phone: 916-646-6631