Provider Demographics
NPI:1154583433
Name:KIRSCH, ROBERT WARREN
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WARREN
Last Name:KIRSCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 SWEETSAGE CT
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-2217
Mailing Address - Country:US
Mailing Address - Phone:805-733-7744
Mailing Address - Fax:
Practice Address - Street 1:401 E CYPRESS AVE
Practice Address - Street 2:PATHPOINT LOMPOC LIFE SKILLS
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-6806
Practice Address - Country:US
Practice Address - Phone:805-737-7718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health