Provider Demographics
NPI:1346485489
Name:NAVARRA, ROBERT (LMFT)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:NAVARRA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 EATON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-5234
Mailing Address - Country:US
Mailing Address - Phone:650-593-8087
Mailing Address - Fax:
Practice Address - Street 1:1209 EATON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-5234
Practice Address - Country:US
Practice Address - Phone:650-593-8087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC15997106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist