Demetria Dominique Roberts
Behavior Technician in San Jose, CA. Individual provider (NPI-1).
NPI number1972321933
StatusActive
Last updated in NPPESSep 30, 2024
Details
- NPI
- 1972321933
- Entity type
- Individual (NPI-1)
- Name
- Demetria Dominique Roberts
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 30, 2024
- Certification date
- Sep 30, 2024
- Last updated
- Sep 30, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1887 Monterey Hwy Ste 225San Jose, CA 95112-6192
Phone 855-223-7123 · Fax 619-374-7134
Mailing address
Po Box 33568San Diego, CA 92163-3568
Phone 855-223-7123 · Fax 619-374-7134
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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