Provider Demographics
NPI:1730505538
Name:OLTHOFF, ROBERT K (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:K
Last Name:OLTHOFF
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 TEAKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-4062
Mailing Address - Country:US
Mailing Address - Phone:805-376-0156
Mailing Address - Fax:
Practice Address - Street 1:875 TEAKWOOD CT
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-4062
Practice Address - Country:US
Practice Address - Phone:805-376-0156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT37050106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist