Provider Demographics
NPI:1164633756
Name:BOYLE, ROBERT CLARK (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CLARK
Last Name:BOYLE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 991826
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96099-1826
Mailing Address - Country:US
Mailing Address - Phone:530-244-5833
Mailing Address - Fax:866-647-3121
Practice Address - Street 1:429 REDCLIFF DR
Practice Address - Street 2:SUITE 225
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0167
Practice Address - Country:US
Practice Address - Phone:530-524-4036
Practice Address - Fax:866-576-5971
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY119900103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY11990OtherPSYCHOLOGIST
CAPSY11990OtherPSYCHOLOGIST