MEDICARE: ROBERTA K LAWSON

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	167G00000X	Licensed Psychiatric Technician	35933	CA

General Provider Information

NPI Number	:	1528914751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERTA K LAWSON

Provider Business Mailing Address
First Line	:	6083 N FIGARDEN DR
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-3226
Country	:	US
Telephone Number	:	760-577-5174
Fax Number	:

Provider Business Practice Location Address
First Line	:	9031 BRYCE CANYON LN
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93306-7157
Country	:	US
Telephone Number	:	559-817-5379
Fax Number	:

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

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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