MEDICARE: JOANNE ROBYN ROLSTON-MARTIN MFT

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	152673	CA

General Provider Information

NPI Number	:	1619483377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNE ROBYN ROLSTON-MARTIN MFT

Provider Business Mailing Address
First Line	:	4739 WILLIS AVE
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-2683
Country	:	US
Telephone Number	:	818-903-1988
Fax Number	:

Provider Business Practice Location Address
First Line	:	4739 WILLIS AVE
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-2683
Country	:	US
Telephone Number	:	818-903-1988
Fax Number	:

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

Provider Enumeration Date	:	12/18/2017
Last Update Date	:	02/14/2025

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