Provider Demographics
NPI:1174551303
Name:ROBERTS, HANNAH JOY (PSYD)
Entity type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:JOY
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 MONTEREY ST STE A
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-2969
Mailing Address - Country:US
Mailing Address - Phone:805-242-1304
Mailing Address - Fax:
Practice Address - Street 1:1530 MONTEREY ST STE A
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2969
Practice Address - Country:US
Practice Address - Phone:805-242-1304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI630102730103T00000X
MI6301014686103T00000X
CAPSY27352103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist