Organization
ROBERTS MEDICAL PSYCHOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLAN RAY ROBERTS PH.D. (PRESIDENT)
(505) 312-7070
Entity
Organization
Contact information
Practice address
2929 COORS BLVD NW, 201H, ALBUQUERQUE, NM 87120-1173
(505) 312-7070
(310) 553-5288
Mailing address
1534 REEVES ST, LOS ANGELES, CA 90035-2929
(310) 552-2382
(310) 553-5288
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1255
NM
103TC0700X
Clinical Psychologist
PSY13524
CA
103TP0016X
Prescribing (Medical) Psychologist
Primary
0043
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
57053243
—
NM
05
—
PSY135240
—
CA
Enumeration date
05/28/2010
Last updated
09/29/2016
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