Provider Demographics
NPI:1477644326
Name:EDLING, ROBERT DOBLE (ROBERT EDLING)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DOBLE
Last Name:EDLING
Suffix:
Gender:M
Credentials:ROBERT EDLING
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:DOBLE
Other - Last Name:EDLING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ROBERT EDLING, EDD
Mailing Address - Street 1:1110 MELODY LN STE 122
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5174
Mailing Address - Country:US
Mailing Address - Phone:916-521-5947
Mailing Address - Fax:916-797-0646
Practice Address - Street 1:1110 MELODY LN STE 122
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-5174
Practice Address - Country:US
Practice Address - Phone:916-521-5947
Practice Address - Fax:916-797-0646
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15117103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist