Provider Demographics
NPI:1770783235
Name:ROBLES, BERTHA
Entity type:Individual
Prefix:MS
First Name:BERTHA
Middle Name:
Last Name:ROBLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 N BANNING BLVD
Mailing Address - Street 2:APT. #8
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-4644
Mailing Address - Country:US
Mailing Address - Phone:310-513-8048
Mailing Address - Fax:
Practice Address - Street 1:240 EAST 20TH STREET
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806
Practice Address - Country:US
Practice Address - Phone:562-599-9272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program