Robert Augustus
Individual provider Active NPI Case Manager/Care Coordinator · Pacoima, CA
NPI 1679951602 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1679951602
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 12450 Van Nuys Blvd Ste 200
Pacoima, CA 91331-1393 - Phone
- (818) 896-1161
- Fax
- (818) 896-5069
- NPI assigned
- May 11, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
12450 Van Nuys Blvd Ste 200
Pacoima, CA 91331-1393
Mailing address
12450 Van Nuys Blvd
Suite 200
Pacoima, CA 91331
Phone (818) 896-1161
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6758 | Medicaid | CA | |
| 7420 | Medicaid | CA | |
| 7068 | Medicaid | CA |
Other providers in Pacoima, CA
- Stefanie Ascencio
- Sarah Esther Asiaban
- Roxanne A Aslanian
- Jessica Carolina Rodriguez Astorga
- Atlantic Recovery Services
- John Austin Jr
- Gabriella Avalos Sarceno
- Maria Clementina Avalos
- Mariela Avalos
- Amanda Avila
All providers in Pacoima, CA · Case Manager/Care Coordinator in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.