Provider Demographics
NPI:1275694481
Name:WEATHERS, ROBERT STANLEY (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STANLEY
Last Name:WEATHERS
Suffix:
Gender:M
Credentials:PHD
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Other - Credentials:
Mailing Address - Street 1:2618 SAN MIGUEL DR STE 1250
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5437
Mailing Address - Country:US
Mailing Address - Phone:310-383-7532
Mailing Address - Fax:
Practice Address - Street 1:15615 ALTON PKWY STE 220
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-7305
Practice Address - Country:US
Practice Address - Phone:310-383-7532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)