Provider Demographics
NPI:1295142826
Name:ADAMS, ROSHAWN RENEE (CADC III)
Entity type:Individual
Prefix:
First Name:ROSHAWN
Middle Name:RENEE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1849 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-3810
Mailing Address - Country:US
Mailing Address - Phone:707-563-7272
Mailing Address - Fax:707-558-8196
Practice Address - Street 1:251 GEORGIA ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5905
Practice Address - Country:US
Practice Address - Phone:707-558-8195
Practice Address - Fax:707-558-8196
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB00002810223101YM0800X
172V00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health