Provider Demographics
NPI:1891845772
Name:BROHMER, ROBERT PAUL (LMFT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PAUL
Last Name:BROHMER
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 1:1111 SONOMA AVE STE 324
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4820
Mailing Address - Country:US
Mailing Address - Phone:707-480-5552
Mailing Address - Fax:
Practice Address - Street 1:1111 SONOMA AVE STE 324
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4820
Practice Address - Country:US
Practice Address - Phone:707-843-5192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 32286106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1891845772OtherNON MEDICAL HOME CARE