Healthcare Provider Details

I. General information

NPI: 1750365060
Provider Name (Legal Business Name): ROBERT E PARKER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56589 OAKWOOD DR
YUCCA VALLEY CA
92284-2221
US

IV. Provider business mailing address

56589 OAKWOOD DR
YUCCA VALLEY CA
92284-2221
US

V. Phone/Fax

Practice location:
  • Phone: 206-240-9880
  • Fax:
Mailing address:
  • Phone: 206-240-9880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1487
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY26862
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: