Healthcare Provider Details

I. General information

NPI: 1225231426
Provider Name (Legal Business Name): ROBERT ELLIOTT LLAMAS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 OCEAN VIEW BLVD #212
MONTROSE CA
91020-1243
US

IV. Provider business mailing address

4343 OCEAN VIEW BLVD #212
MONTROSE CA
91020-1243
US

V. Phone/Fax

Practice location:
  • Phone: 818-249-3133
  • Fax:
Mailing address:
  • Phone: 818-249-3133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY7245
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY7245
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPSY7245
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number7775
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: