Healthcare Provider Details

I. General information

NPI: 1104525021
Provider Name (Legal Business Name): ROBLEK MESHEL ANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44447 10TH ST W
LANCASTER CA
93534-3324
US

IV. Provider business mailing address

23824 HAWTHORNE BLVD STE 200
TORRANCE CA
90505-5935
US

V. Phone/Fax

Practice location:
  • Phone: 323-872-2838
  • Fax:
Mailing address:
  • Phone: 310-791-3064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW122461
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: