Provider Demographics
NPI:1083633721
Name:ROBLES, LYDIA GOMEZ (MFT)
Entity Type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:GOMEZ
Last Name:ROBLES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4618 BLANCA DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2620
Mailing Address - Country:US
Mailing Address - Phone:714-827-2480
Mailing Address - Fax:
Practice Address - Street 1:16600 WOODRUFF AVE STE 102
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-4916
Practice Address - Country:US
Practice Address - Phone:562-920-1600
Practice Address - Fax:562-920-0895
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC20320106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist