Provider Demographics
NPI:1922283795
Name:BOYD, ROBERT OWEN (PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:OWEN
Last Name:BOYD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 PLEASANT HILL ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523
Mailing Address - Country:US
Mailing Address - Phone:925-330-6932
Mailing Address - Fax:925-609-8723
Practice Address - Street 1:2800 PLEASANT HILL ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523
Practice Address - Country:US
Practice Address - Phone:925-330-6932
Practice Address - Fax:925-609-8723
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-29
Last Update Date:2007-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8158103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist