Healthcare Provider Details

I. General information

NPI: 1629230099
Provider Name (Legal Business Name): MR. DENNIS M ROBLES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DENNIS M ROBLES MFT

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2258 SANTA CLARA AVE STE 4
ALAMEDA CA
94501-4473
US

IV. Provider business mailing address

2258 SANTA CLARA AVE #4
ALAMEDA CA
94501
US

V. Phone/Fax

Practice location:
  • Phone: 510-337-9408
  • Fax: 510-337-9408
Mailing address:
  • Phone: 510-337-9408
  • Fax: 510-337-9408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC22446
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: