Provider Demographics
NPI:1043612914
Name:BELANGER, ROBERT ZENON (MA, MFT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ZENON
Last Name:BELANGER
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 BARRANCA PKWY
Mailing Address - Street 2:SUITE 252
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4711
Mailing Address - Country:US
Mailing Address - Phone:661-332-8015
Mailing Address - Fax:949-209-4321
Practice Address - Street 1:4010 BARRANCA PKWY
Practice Address - Street 2:SUITE 252
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604
Practice Address - Country:US
Practice Address - Phone:661-332-8015
Practice Address - Fax:949-209-4321
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90271106H00000X
CA69018106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist