Provider Demographics
NPI:1417270109
Name:ROBLES, ENEDINA ANTONIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ENEDINA
Middle Name:ANTONIA
Last Name:ROBLES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:ENEDINA
Other - Middle Name:ANNA
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:575 E LOCUST AVE STE 171
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2928
Mailing Address - Country:US
Mailing Address - Phone:559-288-3164
Mailing Address - Fax:559-473-4731
Practice Address - Street 1:575 E LOCUST AVE STE 171
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2928
Practice Address - Country:US
Practice Address - Phone:559-288-3164
Practice Address - Fax:559-473-4731
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA259931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical