Provider Demographics
NPI:1740473552
Name:HORON, ROBERT JOHN (PHD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:HORON
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 1:1580 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2841
Mailing Address - Country:US
Mailing Address - Phone:707-258-8757
Mailing Address - Fax:707-253-0457
Practice Address - Street 1:1580 1ST ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-2841
Practice Address - Country:US
Practice Address - Phone:707-258-8757
Practice Address - Fax:707-253-0457
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15003103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY150030Medicaid
CAPSY150030Medicaid