Provider Demographics
NPI:1417930561
Name:MARSELLE, ROBERT ALAN (PSYD, RN)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:MARSELLE
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Gender:M
Credentials:PSYD, RN
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Mailing Address - Street 1:27201 TOURNEY RD
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1854
Mailing Address - Country:US
Mailing Address - Phone:661-312-8033
Mailing Address - Fax:661-244-4415
Practice Address - Street 1:27201 TOURNEY RD STE 201
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1804
Practice Address - Country:US
Practice Address - Phone:661-312-8033
Practice Address - Fax:661-244-4415
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2018-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY16489103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHK503AMedicare UPIN
CACA114094Medicare UPIN