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General NPI Number Information
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NPI Number | 1194435628
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Entity Type | Individual
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Provider Name | ROBERT RODARTE GALVAN
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Gender | Male
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Dates
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Enumeration Date | 11/23/2022
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 225 W BROADWAY STE 155
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City | GLENDALE
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State | CA
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Zip | 91204-1332
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Country | US
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Telephone | 818-333-8293
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Fax | 818-441-0013
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Provider Business Mailing Address
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Address Line | 22158 VALERIO ST
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City | CANOGA PARK
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State | CA
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Zip | 91303-1116
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Country | US
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Telephone | 818-269-8154
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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