| Doctor Name: | DR. TIFFANY JUTERBOCK ROBERTS |
| NPI Number: | 1003100728 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD, LMFT 53905 |
| License Number: | IMFT63510 |
| Business Practice Address: | 45111 Fern Ave Lancaster, CA - 93534 |
| Business Phone Number: | 6619491206 |
| Business Fax Number: | 6619405452 |
| Mailing Address: | 45111 Fern Ave, LANCASTER |
| State: | CA |
| Postal Code: | 93534 |
| Phone Number: | 6619491206 |
| Fax Number: | 6619405452 |
| NPI Enumeration Date: | 05/31/2011 |
| NPI Last Update Date: | 04/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YS0200X |
| License Number: | IMFT63510 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |