Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Robert Carl Ketchum, CATC1

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1487025136

Mr. Robert Carl Ketchum, CATC1 is an Addiction (Substance Use Disorder) Counselor in San Jacinto, California. Licensed in California. Registered with an NPI since 2015.

Licensed in
CA
In the registry since
2015
Specialties on file
3
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Practice location Address checks out

1370 S State St Ste A
San Jacinto, CA 92583-4922
Phone: (951) 791-3350
Fax: (951) 791-3353
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence C054940518 (CA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence K1208311033 (CA)
Case Manager/Care Coordinator Taxonomy 171M00000X · Licence C054940518 (CA)

Record details

NPI number1487025136
Entity typeIndividual (Type 1)
GenderMale
Credentials CATC1
Sole proprietorNo
NPI enumeratedOctober 7, 2015
Last updated in NPPESApril 16, 2024
Certification dateApril 14, 2024

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