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General NPI Number Information
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NPI Number | 1346879517
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Entity Type | Individual
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Provider Name | ROBERT PLAVAJKA
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Gender | Male
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 2677 N MAIN ST STE 130
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City | SANTA ANA
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State | CA
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Zip | 92705-6665
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Country | US
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Telephone | 800-801-9833
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Fax |
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Provider Business Mailing Address
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Address Line | 19510 VAN BUREN BLVD # F3-1027
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City | RIVERSIDE
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State | CA
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Zip | 92508-9457
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Country | US
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Telephone | 951-323-9464
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 131336
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License Number State | CA
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