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NPI Code Detail

MEDICARE: ROBERT ROLLO LABERGE L.M.F.T.

MEDICARE:   ROBERT ROLLO LABERGE  L.M.F.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC22307CA

General Provider Information

NPI Number : 1407994023
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT ROLLO LABERGE L.M.F.T.
Provider Business Mailing Address
First Line : PO BOX 2398
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94064-2398
Country : US
Telephone Number : 650-368-1351
Fax Number : 650-364-9954
Provider Business Practice Location Address
First Line : 617 VETERANS BLVD
Second Line : SUITE 210
City : REDWOOD CITY
State : CA
Zip : 94063-1496
Country : US
Telephone Number : 650-368-1351
Fax Number : 650-364-9954
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2007
Last Update Date : 07/08/2007

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Directions to “ ROBERT ROLLO LABERGE L.M.F.T.” Practice Location

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