Healthcare Provider Details

I. General information

NPI: 1699869222
Provider Name (Legal Business Name): ROBIN THOMAS BOSCARELLI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROBIN CAROL THOMAS PH.D.

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 WILLIAMS DR STE 200
OXNARD CA
93036-0673
US

IV. Provider business mailing address

533 NORTH PECK ROAD
SANTA PAULA CA
93060-1847
US

V. Phone/Fax

Practice location:
  • Phone: 805-973-1489
  • Fax:
Mailing address:
  • Phone: 805-933-3190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberCA PSY 14464
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberPSY14464
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: