Healthcare Provider Details

I. General information

NPI: 1174909824
Provider Name (Legal Business Name): RONALD H ROBERTS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2015
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 TIBURON BLVD # G1
TIBURON CA
94920-2564
US

IV. Provider business mailing address

2000 VAN NESS AVE STE 512
SAN FRANCISCO CA
94109-3017
US

V. Phone/Fax

Practice location:
  • Phone: 415-776-2000
  • Fax:
Mailing address:
  • Phone: 415-776-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY 8334
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY 8334
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: