Healthcare Provider Details

I. General information

NPI: 1689879868
Provider Name (Legal Business Name): SUSAN JANE ROBINETTE MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 ESTUDILLO AVE STE N
SAN LEANDRO CA
94577-4600
US

IV. Provider business mailing address

1108 BISSELL AVE
RICHMOND CA
94801-3135
US

V. Phone/Fax

Practice location:
  • Phone: 510-677-5347
  • Fax: 510-352-4223
Mailing address:
  • Phone: 510-231-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number250079431
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 42326
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: