Provider Demographics
NPI:1326394073
Name:ROMANDIA, ROBERTO GABRIEL (EDD, IABMCP)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:GABRIEL
Last Name:ROMANDIA
Suffix:
Gender:M
Credentials:EDD, IABMCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1279 W HENDERSON AVE
Mailing Address - Street 2:PMB # 267
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-1454
Mailing Address - Country:US
Mailing Address - Phone:559-202-9643
Mailing Address - Fax:
Practice Address - Street 1:2142 W CHERYLL CT
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-7501
Practice Address - Country:US
Practice Address - Phone:559-784-8095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACALIF. BBS, LEP 2361103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist