Healthcare Provider Details

I. General information

NPI: 1215343710
Provider Name (Legal Business Name): ROBERT LIM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2014
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 SANTA CRUZ AVE STE 200
MENLO PARK CA
94025-4643
US

IV. Provider business mailing address

899 SANTA CRUZ AVE STE 200
MENLO PARK CA
94025-4643
US

V. Phone/Fax

Practice location:
  • Phone: 510-804-5565
  • Fax: 855-975-0618
Mailing address:
  • Phone: 510-804-5565
  • Fax: 855-975-0618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY27660
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: