MEDICARE: JOHN H ROBLES MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	18502	CA
2	101YM0800X	Mental Health Counselor	25185	CA
3	1041C0700X	Clinical Social Worker	29581	CA

General Provider Information

NPI Number	:	1245372325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN H ROBLES MSW

Provider Business Mailing Address
First Line	:	PO BOX 484
Second Line	:
City	:	CLAREMONT
State	:	CA
Zip	:	91711-0484
Country	:	US
Telephone Number	:	909-277-1034
Fax Number	:

Provider Business Practice Location Address
First Line	:	349 E AVENUE K6 STE A
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93535-4548
Country	:	US
Telephone Number	:	661-723-4260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	04/09/2019

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