Provider Demographics
NPI:1649364274
Name:ROBERTS, GABRIELE E (LMFT)
Entity type:Individual
Prefix:
First Name:GABRIELE
Middle Name:E
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 E COOLEY DR
Mailing Address - Street 2:SUITE 200 S
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-3981
Mailing Address - Country:US
Mailing Address - Phone:909-424-0209
Mailing Address - Fax:909-424-0222
Practice Address - Street 1:1420 E COOLEY DR
Practice Address - Street 2:SUITE 200 S
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-3981
Practice Address - Country:US
Practice Address - Phone:909-424-0209
Practice Address - Fax:909-424-0222
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41773101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health