Provider Demographics
NPI:1982785507
Name:HARRIS, ROBERT JR (MSW, JD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:HARRIS
Suffix:JR
Gender:M
Credentials:MSW, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:759 BALRA DR
Mailing Address - Street 2:
Mailing Address - City:EL CERRITO
Mailing Address - State:CA
Mailing Address - Zip Code:94530-3302
Mailing Address - Country:US
Mailing Address - Phone:510-647-9936
Mailing Address - Fax:415-473-6313
Practice Address - Street 1:3270 KERNER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-4840
Practice Address - Country:US
Practice Address - Phone:415-473-6799
Practice Address - Fax:415-473-6313
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical