Provider Demographics
NPI:1447680707
Name:AERTS, ROBERT PAUL
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:PAUL
Last Name:AERTS
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 1:18409 OUTER HWY 18 STE 2
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2228
Mailing Address - Country:US
Mailing Address - Phone:760-946-0804
Mailing Address - Fax:
Practice Address - Street 1:18409 OUTER HWY 18 STE 2
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2228
Practice Address - Country:US
Practice Address - Phone:760-946-0804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA113139106H00000X
CA111486106H00000X
CAIMF73903101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health