Healthcare Provider Details

I. General information

NPI: 1710271820
Provider Name (Legal Business Name): MELANIE EVA ROBERSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CALIFORNIA ST STE 2300
SAN FRANCISCO CA
94111-5424
US

IV. Provider business mailing address

900 COTTAGE GROVE RD
BLOOMFIELD CT
06002-2920
US

V. Phone/Fax

Practice location:
  • Phone: 800-997-6196
  • Fax: 833-523-9924
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD95944
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101252683
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: