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

Joaquin Lopez de San Roman

Individual provider Marriage & Family Therapist · NPI 1215482773

Joaquin Lopez de San Roman is a Marriage & Family Therapist in Sebastopol, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2016

Practice location Address checks out

2650 Burnside Rd
Sebastopol, CA 95472-9424
Phone: (707) 328-1793
Fax: (707) 664-4104
Show map & directions

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

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 45971 (CA)

Record details

NPI number1215482773
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 24, 2016
Last updated in NPPESAugust 24, 2016

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