Provider Demographics
NPI:1023248499
Name:LOEPER, ROBERT (MFTI)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:LOEPER
Suffix:
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 IRWIN LN
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-5603
Mailing Address - Country:US
Mailing Address - Phone:707-246-7920
Mailing Address - Fax:707-648-0393
Practice Address - Street 1:229 NEWBURY WAY
Practice Address - Street 2:
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-4228
Practice Address - Country:US
Practice Address - Phone:707-360-1511
Practice Address - Fax:707-360-1540
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 49240106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist