Provider Demographics
NPI:1710974886
Name:LANDO, ROBERT E (MSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:LANDO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:E
Other - Last Name:LANDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:2021 FIELDSTONE CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-7915
Mailing Address - Country:US
Mailing Address - Phone:707-344-3249
Mailing Address - Fax:866-582-6950
Practice Address - Street 1:419 MASON ST
Practice Address - Street 2:SUITE 214
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95688-4597
Practice Address - Country:US
Practice Address - Phone:707-344-3249
Practice Address - Fax:866-582-6950
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS143991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALCS14399OtherSOCIAL WORK LICENSE