Provider Demographics
NPI:1306732037
Name:ENFIELD, ROBERT RAYMOND JR (CHW0000000652)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:RAYMOND
Last Name:ENFIELD
Suffix:JR
Gender:M
Credentials:CHW0000000652
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2428 E APACHE BLVD STE 123
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85288-2382
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2428 E APACHE BLVD STE 123
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85288-2382
Practice Address - Country:US
Practice Address - Phone:602-361-4805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZCHW0000000652172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker