Provider Demographics
NPI:1275574691
Name:PICKER, ROBERT I (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:I
Last Name:PICKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1399 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE 25
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2884
Mailing Address - Country:US
Mailing Address - Phone:925-945-8440
Mailing Address - Fax:924-945-8448
Practice Address - Street 1:1399 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE 25
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2884
Practice Address - Country:US
Practice Address - Phone:925-945-8440
Practice Address - Fax:924-945-8448
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG195052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G195051Medicare ID - Type Unspecified
CAA40669Medicare UPIN