Provider Demographics
NPI:1811423908
Name:ROBERTS, ZACHARY T (MD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:T
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ZACH
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5575 W LAS POSITAS BLVD STE 330
Mailing Address - Street 2:MAIL CODE 7976
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-5804
Mailing Address - Country:US
Mailing Address - Phone:650-723-6469
Mailing Address - Fax:
Practice Address - Street 1:5575 W LAS POSITAS BLVD STE 330
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-5804
Practice Address - Country:US
Practice Address - Phone:650-723-6469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1887102084N0400X, 2084E0001X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy