Provider Demographics
NPI:1720586175
Name:ROBLES, RUBEN I (LMFT)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:I
Last Name:ROBLES
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 TERRACINA BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373
Mailing Address - Country:US
Mailing Address - Phone:909-798-1763
Mailing Address - Fax:909-307-6405
Practice Address - Street 1:255 TERRACINA BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373
Practice Address - Country:US
Practice Address - Phone:909-798-1763
Practice Address - Fax:909-307-6405
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT39978106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist