Healthcare Provider Details

I. General information

NPI: 1598173163
Provider Name (Legal Business Name): NATASHA CHLOE ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 12/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 W FOOTHILL BLVD # 300
ARCADIA CA
91006-2338
US

IV. Provider business mailing address

578 WASHINGTON BLVD
MARINA DEL REY CA
90292-5442
US

V. Phone/Fax

Practice location:
  • Phone: 323-543-2800
  • Fax:
Mailing address:
  • Phone: 443-804-2314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number35597
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW85320
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number85320
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: