Provider Demographics
NPI:1477170876
Name:ROBERTS, JANET ELIZABETH
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:ELIZABETH
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 TRUXEL RD APT 179
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-3713
Mailing Address - Country:US
Mailing Address - Phone:530-355-8786
Mailing Address - Fax:
Practice Address - Street 1:333 UNIVERSITY AVE STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6540
Practice Address - Country:US
Practice Address - Phone:530-355-8786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician