Provider Demographics
NPI:1558418186
Name:FIELD, ROBERT BRUCE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRUCE
Last Name:FIELD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 SAN RAMON VALLEY BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-4036
Mailing Address - Country:US
Mailing Address - Phone:925-743-1370
Mailing Address - Fax:925-743-1937
Practice Address - Street 1:2333 SAN RAMON VALLEY BLVD STE 125
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1613
Practice Address - Country:US
Practice Address - Phone:925-743-1370
Practice Address - Fax:925-743-1937
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 5705103T00000X
CA5705103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PL57050Medicare ID - Type Unspecified