STACY ROUDEBUSH
NPI 1730559303
Substance Abuse Rehabilitation Facility in Rohnert Park, CA

Q: What is Stacy Roudebush's NPI number?

The NPI number for Stacy Roudebush is 1730559303. It was assigned to this individual provider in the NPPES registry on September 25, 2015.

Q: What is Stacy Roudebush's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Q: When was this NPI record last updated?

The NPPES record for Stacy Roudebush was last updated on September 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 25, 2015

308 FIRETHORN DR, ROHNERT PARK, CA 94928(619) 723-0385 Get Directions Write a Review

NPPES record last updated: September 25, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Stacy Roudebush NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACY ROUDEBUSH (NPI 1730559303) is an individual substance abuse rehabilitation facility provider in Rohnert Park, California, licensed in California (B6655711) and active in the NPI registry since September 2015.

NPPES Registry Identity

NPI1730559303

Entity TypeIndividualFemale

Primary Taxonomy324500000X

Provider Legal NameSTACY ROUDEBUSH

Location Address308 FIRETHORN DRRohnert Park, CA 94928-1321

Mailing Address308 Firethorn DrRohnert Park, CA 94928-1321 · (619) 723-0385

Phone(619) 723-0385

Sole ProprietorYes

Enumeration DateSeptember 25, 2015

✔ NPI 1730559303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities

Taxonomy Code324500000X

License✔ Licensed in CA · B6655711

Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

308 FIRETHORN DR, Rohnert Park, CA 94928

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Other Identifiers 1

MedicaidB6655711CA

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM J SMITH

Counselor (Addiction (Substance Use Disorder))

308 FIRETHORN DR
ROHNERT PARK, CA 94928

Sonoma County (510) 459-8905

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy Roudebush's NPI number?

The NPI number for Stacy Roudebush is 1730559303. It was assigned to this individual provider in the NPPES registry on September 25, 2015.

Where is Stacy Roudebush located?

Stacy Roudebush practices at 308 Firethorn Dr, Rohnert Park, CA 94928. The listed phone number is (619) 723-0385.

What is Stacy Roudebush's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Stacy Roudebush was last updated on September 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.