Healthcare Provider Details

I. General information

NPI: 1902551278
Provider Name (Legal Business Name): ROBERT A LUQUE JR. AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7701 PRISM WAY
BAKERSFIELD CA
93313-5087
US

IV. Provider business mailing address

PO BOX 7928
VENTURA CA
93006-7928
US

V. Phone/Fax

Practice location:
  • Phone: 661-885-6006
  • Fax:
Mailing address:
  • Phone: 805-766-1472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number20614
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT125584
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: