Provider Demographics
NPI:1174899736
Name:LA VOGUE, ROBERT (CADC II)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:LA VOGUE
Suffix:
Gender:M
Credentials:CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11501 DOLAN AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4921
Mailing Address - Country:US
Mailing Address - Phone:562-923-7894
Mailing Address - Fax:562-319-5549
Practice Address - Street 1:11501 DOLAN AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4921
Practice Address - Country:US
Practice Address - Phone:562-923-7894
Practice Address - Fax:562-869-3400
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)