Provider Demographics
NPI:1285018861
Name:LESTER, ROBERT TIMOTHY
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:TIMOTHY
Last Name:LESTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58945 BUSINESS CENTER DR
Mailing Address - Street 2:STE J
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-7307
Mailing Address - Country:US
Mailing Address - Phone:760-369-1074
Mailing Address - Fax:760-369-1293
Practice Address - Street 1:58945 BUSINESS CENTER DR
Practice Address - Street 2:STE J
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-7307
Practice Address - Country:US
Practice Address - Phone:760-369-1074
Practice Address - Fax:760-369-1293
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor