Provider Demographics
NPI:1629230099
Name:ROBLES, DENNIS M
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:M
Last Name:ROBLES
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:DENNIS
Other - Middle Name:M
Other - Last Name:ROBLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:2258 SANTA CLARA AVE #4
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501
Mailing Address - Country:US
Mailing Address - Phone:510-337-9408
Mailing Address - Fax:510-337-9408
Practice Address - Street 1:2258 SANTA CLARA AVE STE 4
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4473
Practice Address - Country:US
Practice Address - Phone:510-337-9408
Practice Address - Fax:510-337-9408
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
CAMFC22446106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional