Healthcare Provider Details

I. General information

NPI: 1881804144
Provider Name (Legal Business Name): ALISTAIR ROBERTSON MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL
MADERA CA
93638-8761
US

IV. Provider business mailing address

2390 25TH AVE
KINGSBURG CA
93631-1425
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-5270
  • Fax:
Mailing address:
  • Phone: 559-897-0621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: