Provider Demographics
NPI:1124706361
Name:WEISS, ROBERT (MSW)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:WEISS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 ADELAIDE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90402-1227
Mailing Address - Country:US
Mailing Address - Phone:310-210-7556
Mailing Address - Fax:
Practice Address - Street 1:14945 VENTURA BLVD STE 308
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5914
Practice Address - Country:US
Practice Address - Phone:310-210-7556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS149451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical