Provider Demographics
NPI:1942640529
Name:GROVE, ROBERT NELSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NELSON
Last Name:GROVE
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 1:82704 SUTTON DR
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203
Mailing Address - Country:US
Mailing Address - Phone:760-363-4001
Mailing Address - Fax:888-333-5114
Practice Address - Street 1:79301 COUNTRY CLUB DR
Practice Address - Street 2:STE 101
Practice Address - City:BERMUDA DUNES
Practice Address - State:CA
Practice Address - Zip Code:92203-1250
Practice Address - Country:US
Practice Address - Phone:760-636-4001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6441103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical