Healthcare Provider Details

I. General information

NPI: 1609545565
Provider Name (Legal Business Name): ROBERT M TURNER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 AEGEAN WAY APT 170
VACAVILLE CA
95687-4078
US

IV. Provider business mailing address

209 AEGEAN WAY APT 170
VACAVILLE CA
95687-4078
US

V. Phone/Fax

Practice location:
  • Phone: 107-075-9294
  • Fax:
Mailing address:
  • Phone: 107-075-9294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: