Provider Demographics
NPI:1629583539
Name:SIBBETT-ROBLES, AMBER SHERRIE
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:SHERRIE
Last Name:SIBBETT-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 1:1300 S GRAND AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-4434
Mailing Address - Country:US
Mailing Address - Phone:818-384-3588
Mailing Address - Fax:
Practice Address - Street 1:1300 SOUTH GRAND AVE
Practice Address - Street 2:BUILDING B
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705
Practice Address - Country:US
Practice Address - Phone:714-480-6476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118562106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1629583539OtherNPI NUMBER