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General NPI Number Information
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NPI Number | 1518179191
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Entity Type | Organization
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Legal Business Name | ROUBICEK & SHAW
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1879 E FIR AVE SUITE 103
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City | FRESNO
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State | CA
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Zip | 93720-3841
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Country | US
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Telephone | 559-323-8484
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Fax | 559-323-8686
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Provider Business Mailing Address
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Address Line | 1879 E FIR AVE SUITE 103
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City | FRESNO
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State | CA
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Zip | 93720-3841
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Country | US
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Telephone | 559-323-8484
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Fax | 559-323-8686
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL CLARK ROUBICEK
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Credential | PH.D., LCSW
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Telephone | 559-323-8484
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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 | 43024
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 42972
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 15811
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License Number State | CA
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