Provider Demographics
NPI:1861428971
Name:MYERS, ROBERT F (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:MYERS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 N WANDA ROAD
Mailing Address - Street 2:SUITE 120 V3
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-2097
Mailing Address - Country:US
Mailing Address - Phone:562-243-3200
Mailing Address - Fax:
Practice Address - Street 1:14600 SHERMAN WAY STE 220
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-5851
Practice Address - Country:US
Practice Address - Phone:909-294-6478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY6211103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical