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

Ethan Roberts

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1497193585

Ethan Roberts is a Clinical Psychologist in El Cerrito, California. Qualified in 2017, 9 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2013

Practice location Address checks out

722 Norvell St
El Cerrito, CA 94530-3246
Phone: (510) 647-9836
Show map & directions

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

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1497193585
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 11, 2013
Last updated in NPPESFebruary 11, 2022
Mailing address722 Norvell St, El Cerrito, CA 94530-3246

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in El Cerrito