Provider Demographics
NPI:1568617280
Name:ABBOTT-FLOREZ, ROBERT RAY (MA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:RAY
Last Name:ABBOTT-FLOREZ
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-8141
Mailing Address - Country:US
Mailing Address - Phone:707-769-4455
Mailing Address - Fax:
Practice Address - Street 1:915 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-8141
Practice Address - Country:US
Practice Address - Phone:707-769-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor