| Doctor Name: | MR. ROBERT PHILLIPS |
| NPI Number: | 1023282654 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MASTERS/RAS |
| License Number: | P0412151238 |
| Business Practice Address: | 419 Pennsylvania St Vallejo, CA - 945906933 |
| Business Phone Number: | 7076432715 |
| Business Fax Number: | 7076438536 |
| Mailing Address: | 419 Pennsylvania St, VALLEJO |
| State: | CA |
| Postal Code: | 945906933 |
| Phone Number: | 7076432715 |
| Fax Number: | 7076438536 |
| NPI Enumeration Date: | 04/15/2008 |
| NPI Last Update Date: | 04/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | P0412151238 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |