Provider Demographics
NPI:1750860771
Name:KEARNEY, BOBBIE ROSE (LCSW)
Entity type:Individual
Prefix:
First Name:BOBBIE
Middle Name:ROSE
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BOBBIE
Other - Middle Name:ROSE
Other - Last Name:PARRELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12830 CYPRESS AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-3825
Mailing Address - Country:US
Mailing Address - Phone:909-573-9876
Mailing Address - Fax:
Practice Address - Street 1:85 RAMONA EXPY
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571-7014
Practice Address - Country:US
Practice Address - Phone:951-349-4190
Practice Address - Fax:951-490-0123
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA964061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical