Healthcare Provider Details

I. General information

NPI: 1932758695
Provider Name (Legal Business Name): ROBERT E PARKER, PHD., A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2019
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 TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT E PARKER
Title or Position: PRESIDENT
Credential: PHD
Phone: 206-240-9880