Healthcare Provider Details

I. General information

NPI: 1225483902
Provider Name (Legal Business Name): ANTHONY RAY ROBLES MFT-I
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2016
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 W SHAW AVE STE 102
FRESNO CA
93711-3249
US

IV. Provider business mailing address

3433 W SHAW AVE STE 107
FRESNO CA
93711-3229
US

V. Phone/Fax

Practice location:
  • Phone: 559-374-3990
  • Fax:
Mailing address:
  • Phone: 559-476-2115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number160510
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: