Individual
JOSE GUADALUPE ROBLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1401 FULTON ST STE 200, FRESNO, CA 93721-1646
(559) 348-9225
Mailing address
1401 FULTON ST STE 200, FRESNO, CA 93721-1646
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639557655
MEDI-CAL
CA
Enumeration date
05/13/2020
Last updated
05/13/2020
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