Healthcare Provider Details

I. General information

NPI: 1730008558
Provider Name (Legal Business Name): SUSAN ANN ROBINSON CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8920 EMERALD PARK DR STE C
ELK GROVE CA
95624-2380
US

IV. Provider business mailing address

8920 EMERALD PARK DR STE C
ELK GROVE CA
95624-2380
US

V. Phone/Fax

Practice location:
  • Phone: 916-685-2240
  • Fax: 916-686-2240
Mailing address:
  • Phone: 281-908-2976
  • Fax: 916-686-2240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number100896
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: