Basic Information
| Provider Information | |||||||||
| NPI: | 1275999682 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NOBARI | ||||||||
| FirstName: | ROXANA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 ROLAND WAY | ||||||||
| Address2: | STE 100 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946212027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107462800 | ||||||||
| FaxNumber: | 5107462810 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 ROLAND WAY STE 150 | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946212027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7075761997 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2016 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 113019 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101YP2500X | 7231 | CA | N | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.