Healthcare Provider Details

I. General information

NPI: 1952963290
Provider Name (Legal Business Name): LAUREN OLIVIA ROBLES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 05/04/2024
Certification Date: 05/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALIFORNIA MEN'S COLONY HWY 1 PO BOX 8101
SAN LUIS OBISPO CA
93409-5416
US

IV. Provider business mailing address

PO BOX 8101
SAN LUIS OBISPO CA
93403-8101
US

V. Phone/Fax

Practice location:
  • Phone: 805-547-7900
  • Fax:
Mailing address:
  • Phone: 805-547-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number108447
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: