MARK NICHOLAS ROBERTSON (NPI# 1144336660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144336660 |
| Entity Type | Individual |
| Full Name | MARK NICHOLAS ROBERTSON |
| Practice Address |
1947 N California St Suite C Stockton CA 95204 |
| Mailing Address |
6465 N West Ln Apt 220 Stockton CA 95210 |
| Practice Telephone | 2094630870 |
| Practice Fax Number | 2094630560 |
| Mailing Telephone | 2094729323 |
| Mailing Fax Number | 2094630560 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619324498 | Mark Robertson | Massage Therapist | 8329 76th Ave Ne, Marysville, WA 98270-7602 | 2016-05-20 |
| 1962774521 | Mark B Robertson | Pharmacist | 3699 Hiway 95, Ste 100, Bullhead City, AZ 86442-9118 | 2012-01-29 |
| 1134294937 | Mark Douglas Robertson | Optometrist | 2701 David Mcleod Blvd., Florence, SC 29501 | 2006-11-21 |
| 1487679700 | Mark Stephen Robertson | Otolaryngology | 950 29th Ave Sw, Albany, OR 97321-3415 | 2006-07-13 |
| 1962457697 | Mark Alan Robertson | Otolaryngology | 205 Se Howard Ave, Bartlesville, OK 74006-2204 | 2006-05-23 |
| 1235448150 | Mark Alan Robertson | Dentist | 25 W Water St, Harrisonburg, VA 22801-3624 | 2010-09-27 |
| 1326278003 | Mark Robertson | Physical Therapist | 2021 Vanesta Pl, Suite C, Manhattan, KS 66503-0380 | 2009-07-16 |
| 1821129495 | Mark Eric Robertson | Physical Therapist | 600 W 21st Street, Red Lodge, MT 59068 | 2007-03-08 |
| 1720142466 | Mark Davis Robertson | Optometrist | 503900 Mooty 13 Fishermen Beachroad, Garapan, Saipan, MP 96950-3900 | 2006-12-20 |
| 1063584316 | Mark A Robertson | Pharmacist | 42 Lambert St Ste 311, Staunton, VA 24401-2421 | 2006-11-14 |
| Street Address |
1947 N CALIFORNIA ST SUITE C |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326080862 | Matrix Rehabilitation, Inc. | Clinic/Center | 1947 N California St, Suite B, Stockton, CA 95204-6029 | 2006-06-11 |
| 1093345183 | Kurtis Woody | Licensed Vocational Nurse | 1947 N California St, Stockton, CA 95204-6029 | 2020-01-17 |
| 1588211502 | Roberta Jean Lewis-goldfine | Licensed Vocational Nurse | 1947 N California St, Stockton, CA 95204-6029 | 2019-08-23 |
| 1568945822 | Pa Gnia Yang | Counselor | 1947 N California St, Stockton, CA 95204-6029 | 2018-09-12 |
| 1639669070 | Sioban Regina Mersaroli | Counselor | 1947 N California St, Stockton, CA 95204-6029 | 2018-05-11 |
| 1720580970 | Rana Amjadi Khan | Counselor | 1947 N California St, Stockton, CA 95204-6029 | 2018-03-05 |
| 1548793656 | Marc Heslop | Counselor | 1947 N California St, Stockton, CA 95204-6029 | 2017-04-05 |
| 1376908814 | Stephen Bradley Machado II | Counselor | 1947 N California St, Suite B, Stockton, CA 95204-6029 | 2015-12-29 |
| 1295117174 | Steven Ryan | Case Manager/Care Coordinator | 1947 N California St, B, Stockton, CA 95204-6029 | 2015-06-26 |
| 1083007033 | Josepph Daniel Isquierdo | Counselor | 1947 N California St, Suite B, Stockton, CA 95204-6029 | 2015-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962027524 | Kariem Abdelwahed | Licensed Vocational Nurse | 1630 N. Edison St Stockton Ca, Stockton, CA 95204 | 2020-06-10 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1790228781 | Rebecca Phongsa | Counselor | 1947 North Calfornia Street, Suite B, Stockton, CA 95204 | 2016-11-23 |
| 1700332905 | Serim Kang | Driver | 4222 N Pershing Ave, Suite D2, Stockton, CA 95204 | 2016-08-28 |
| 1033565544 | Philip John Brereton | Orthotist | 466 E Harding Way, Stockton, CA 95204 | 2016-05-13 |
| 1932507522 | David Grayson | Counselor | 1621 Brookside Rd, Stockton, CA 95204 | 2014-12-12 |
| 1174934897 | Gurtej Malhi | Internal Medicine | 1901 N California Street, Stockton, CA 95204 | 2014-05-15 |
| 1396156170 | Rajesh Saini | Nurse Practitioner | 1805 N California St. Suite 102, Stockton, CA 95204 | 2014-05-14 |
| Find all providers in zip 95204 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893155 | Tracey Black | Counselor | 130 W Flora St, Stockton, CA 95202-1636 | 2020-08-25 |
| 1699305508 | Juan Robles | Counselor | 1947 N California St # 95204, Stockton, CA 95204-6029 | 2020-01-20 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1821648353 | Kaye Lynn Scott-roy | Counselor | 285 H Rd, Stockton, KS 67669-8889 | 2019-09-17 |
| 1760049043 | Jay Frank Williams | Counselor | 1105 N El Dorado St, Stockton, CA 95202-1305 | 2019-05-22 |
| 1184105462 | Rachelle Diane Wilson | Counselor | 2733 N Sutter St, Stockton, CA 95204-4548 | 2018-08-24 |
| 1568943835 | Heather Lynn Rogers | Counselor | 3990 Black Butte Cir, Stockton, CA 95209-3500 | 2018-08-24 |
| 1235631722 | Parker Yang | Counselor | 1111 N. El Dorado St, Stockton, CA 95202 | 2018-03-01 |
| 1487162087 | Linda Soun | Counselor | 1111 N. El Dorado Street, Stockton, CA 95202 | 2018-01-17 |
| 1760995781 | Dana Lamont Harris | Counselor | 2833 Buckner Ct, Stockton, CA 95207-2302 | 2017-11-13 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.