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General NPI Number Information
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NPI Number | 1477605194
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Entity Type | Individual
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Provider Name | ROBERT KENNETH SAWICKY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1150 N MOUNTAIN AVE SUITE 102A
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City | UPLAND
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State | CA
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Zip | 91786-3668
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Country | US
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Telephone | 909-946-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 1042 N MOUNTAIN AVE #B392
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City | UPLAND
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State | CA
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Zip | 91786-3695
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Country | US
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Telephone | 909-946-4400
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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 | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | PSY8827
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY8827
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY8827
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License Number State | CA
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