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General NPI Number Information
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NPI Number | 1487340600
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Entity Type | Individual
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Provider Name | NANCY SUZANNE ROBERTS LMFT
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Gender | Female
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Dates
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Enumeration Date | 04/12/2023
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 1342 NM 333 STE C
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City | TIJERAS
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State | NM
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Zip | 87059-7351
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Country | US
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Telephone | 650-762-6761
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Fax |
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Provider Business Mailing Address
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Address Line | 1342 NM 333 STE C
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City | TIJERAS
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State | NM
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Zip | 87059-7351
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 153633
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | CTB-2023-0049
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License Number State | NM
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