MEDICARE: JAIMELEE MARIE ROBERTS LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	158786	CA

General Provider Information

NPI Number	:	1194281857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIMELEE MARIE ROBERTS LMFT

Provider Business Mailing Address
First Line	:	2815 MITCHELL DR
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94598-1623
Country	:	US
Telephone Number	:	925-885-6070
Fax Number	:	925-835-7071

Provider Business Practice Location Address
First Line	:	2815 MITCHELL DR STE 119
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94598-1622
Country	:	US
Telephone Number	:	925-885-6070
Fax Number	:	925-835-7071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2019
Last Update Date	:	01/07/2026

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