Provider Demographics
NPI:1295500304
Name:ROBLES, CONSUELO (CPHT)
Entity type:Individual
Prefix:
First Name:CONSUELO
Middle Name:
Last Name:ROBLES
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10125
Mailing Address - Street 2:
Mailing Address - City:EARLIMART
Mailing Address - State:CA
Mailing Address - Zip Code:93219-0125
Mailing Address - Country:US
Mailing Address - Phone:661-699-7659
Mailing Address - Fax:661-725-3640
Practice Address - Street 1:1017 ELLINGTON ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2621
Practice Address - Country:US
Practice Address - Phone:661-725-9489
Practice Address - Fax:661-725-3640
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker