Basic Information
| Provider Information | |||||||||
| NPI: | 1366014920 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANCHEZ ROBLES | ||||||||
| FirstName: | FERNANDO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10776 FREMONT ST | ||||||||
| Address2: | |||||||||
| City: | YUCAIPA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923999630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9097970114 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 730 MEDICAL CENTER CT | ||||||||
| Address2: | |||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919116618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6198635700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2021 | ||||||||
| LastUpdateDate: | 03/16/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 10594 | CA | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YM0800X | 10594 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.