Healthcare Provider Details

I. General information

NPI: 1932308301
Provider Name (Legal Business Name): DENISE H ROBINSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6615 E PCH #190
LONG BEACH CA
90803
US

IV. Provider business mailing address

6615 E PCH #190
LONG BEACH CA
90803
US

V. Phone/Fax

Practice location:
  • Phone: 562-537-2646
  • Fax: 562-621-0794
Mailing address:
  • Phone: 562-537-2646
  • Fax: 562-621-0794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS21964
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: