Healthcare Provider Details

I. General information

NPI: 1013768290
Provider Name (Legal Business Name): MR. ROBERT FLORENTINO ABAD PASCUAL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16650 SHERMAN WAY
VAN NUYS CA
91406-3782
US

IV. Provider business mailing address

7052 WHITE OAK AVE
LAKE BALBOA CA
91406-3536
US

V. Phone/Fax

Practice location:
  • Phone: 818-901-4836
  • Fax:
Mailing address:
  • Phone: 323-527-7223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT146612
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: