Individual
DR. ROBERT TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAADC, ICAADC, SAP
Contact information
Practice address
28481 RANCHO CALIFORNIA RD STE 101, TEMECULA, CA 92590-3667
(714) 612-7197
(714) 908-3308
Mailing address
34670 CAPITOL ST, TEMECULA, CA 92592-9318
(714) 612-7197
(714) 908-3308
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LR01580715
CA
101YP1600X
Pastoral Counselor
CAWES1-1-011930SM
CA
101YP2500X
Professional Counselor
Primary
LR01580715
CA
Other
Enumeration date
04/14/2017
Last updated
11/08/2021
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