Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jeremy B Roark, PHD

Individual provider Psychologist · NPI 1578860193

Dr. Jeremy B Roark, PHD is a Psychologist in Ada, Michigan. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2011
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2650 Shumac Ln SE
Ada, MI 49301-9355
Phone: (805) 570-7688
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence PSY 24012 (CA)

Record details

NPI number1578860193
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedFebruary 16, 2011
Last updated in NPPESFebruary 1, 2024
Certification dateFebruary 1, 2024

Other providers in Ada