Provider Demographics
NPI:1194435628
Name:GALVAN, ROBERT RODARTE
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:RODARTE
Last Name:GALVAN
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 1:22158 VALERIO ST
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1116
Mailing Address - Country:US
Mailing Address - Phone:818-269-8154
Mailing Address - Fax:
Practice Address - Street 1:225 W BROADWAY STE 155
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1332
Practice Address - Country:US
Practice Address - Phone:818-333-8293
Practice Address - Fax:818-441-0013
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health