MEDICARE: MR. DENNIS M ROBLES

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	101YP2500X	Professional Counselor
2	106H00000X	Marriage & Family Therapist	MFC22446	CA

General Provider Information

NPI Number	:	1629230099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DENNIS M ROBLES

Provider Business Mailing Address
First Line	:	2258 SANTA CLARA AVE #4
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501
Country	:	US
Telephone Number	:	510-337-9408
Fax Number	:	510-337-9408

Provider Business Practice Location Address
First Line	:	2258 SANTA CLARA AVE STE 4
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-4473
Country	:	US
Telephone Number	:	510-337-9408
Fax Number	:	510-337-9408

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

Provider Enumeration Date	:	06/27/2008
Last Update Date	:	06/27/2008

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Directions to “ MR. DENNIS M ROBLES ” Practice Location

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