Robert Mitchell Awalt, PSY.D. AND LCSW

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY16566 Issued in CA

Practice address

3420 Kenyon St
San Diego, CA 92110-5001

Phone

(619) 221-6550

Fax

(619) 221-6556

NPI assigned

Jun 19, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1790980829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3437 UTAH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921044109",
            "telephone_number": "619-221-6589",
            "fax_number": "619-221-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 KENYON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105001",
            "telephone_number": "619-221-6550",
            "fax_number": "619-221-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWALT",
        "first_name": "ROBERT",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "PSY.D. AND LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "PSY16566",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY16566",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY16566",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "PSY16566",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa W Avorh, REGISTERED NURSE
• Holly Avriette, PHD
• Vadim Avulov, D.O.
• George Awad, PHARM D
• Hannah Idiong Awai, M.D.
• Stephanie Lynd Awalt, MA
• Maham Awan
• Danny Awar
• Mohammed Abdulqadir Aways
• Linda Awdishu, BSCPHM

• Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.