Provider Demographics
NPI:1508111030
Name:ROBLES, REBECA
Entity Type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:ROBLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4024 DURFEE AVE WING D
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732
Mailing Address - Country:US
Mailing Address - Phone:323-447-7798
Mailing Address - Fax:
Practice Address - Street 1:4024 DURFEE AVE
Practice Address - Street 2:WING D
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-2510
Practice Address - Country:US
Practice Address - Phone:626-455-4799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner