Provider Demographics
NPI:1366538464
Name:PIMENTEL, ROBERT R (LPHA, ASW)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:R
Last Name:PIMENTEL
Suffix:
Gender:M
Credentials:LPHA, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 O ST APT 1
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-6129
Mailing Address - Country:US
Mailing Address - Phone:916-607-4667
Mailing Address - Fax:
Practice Address - Street 1:3990 BRANCH CENTER RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-3809
Practice Address - Country:US
Practice Address - Phone:916-596-4186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA354131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical