Healthcare Provider Details

I. General information

NPI: 1750920799
Provider Name (Legal Business Name): PAMELA ROBINSON DNP, PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2019
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 E RIO SALADO PKWY STE 900
TEMPE AZ
85281-9126
US

IV. Provider business mailing address

8194 W DEER VALLEY RD # 505
PEORIA AZ
85382-2127
US

V. Phone/Fax

Practice location:
  • Phone: 623-335-2628
  • Fax:
Mailing address:
  • Phone: 602-427-8031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0812X
TaxonomyCommunity Psychiatric/Mental Health Clinical Nurse Specialist
License Number4704333807
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP161033
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number109346
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number109346
License Number StateAK
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number109346
License Number StateAK
# 6
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number109346
License Number StateAK
# 7
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number4704333807
License Number StateMI
# 8
Primary TaxonomyN
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number4704333807
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: