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General NPI Number Information
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NPI Number | 1326394073
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Entity Type | Individual
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Provider Name | ROBERTO GABRIEL ROMANDIA ED.D., IABMCP
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Gender | Male
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 07/31/2012
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Provider Practice Location Address
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Address Line | 2142 W CHERYLL CT
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City | PORTERVILLE
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State | CA
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Zip | 93257-7501
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Country | US
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Telephone | 559-784-8095
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Fax |
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Provider Business Mailing Address
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Address Line | 1279 W HENDERSON AVE PMB # 267
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City | PORTERVILLE
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State | CA
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Zip | 93257-1454
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Country | US
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Telephone | 559-202-9643
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | CALIF. BBS, LEP 2361
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License Number State | CA
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