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General NPI Number Information
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NPI Number | 1619280351
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Entity Type | Individual
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Provider Name | ROBERT PERRY HURST
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Gender | Male
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 07/25/2015
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Provider Practice Location Address
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Address Line | 2450 GRANT ST
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City | CONCORD
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State | CA
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Zip | 94520-2251
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Country | US
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Telephone | 510-773-6848
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16142
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City | OAKLAND
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State | CA
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Zip | 94610-6142
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Country | US
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Telephone | 415-308-4052
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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 | IMF69036
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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 | MFT86906
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License Number State | CA
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