Individual
ANTHONY TYLER ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1148 COLOMA WAY, APT 26-20, ROSEVILLE, CA 95661-4480
(916) 774-6647
Mailing address
1133 COLOMA WAY, ROSEVILLE, CA 95661-4480
(916) 774-6647
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
CA
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
10/20/2022
Last updated
04/22/2025
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