Provider Demographics
NPI:1417773714
Name:SLAY, ROBERT JAMES
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JAMES
Last Name:SLAY
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 1:3530 CAMINO DEL RIO N STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1746
Mailing Address - Country:US
Mailing Address - Phone:619-930-6071
Mailing Address - Fax:
Practice Address - Street 1:3530 CAMINO DEL RIO N STE 300
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1746
Practice Address - Country:US
Practice Address - Phone:619-930-6071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1587051124101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)