Healthcare Provider Details

I. General information

NPI: 1982377412
Provider Name (Legal Business Name): EVEREST ROBINSON LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 07/27/2024
Certification Date: 07/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2677 N MAIN ST STE 130
SANTA ANA CA
92705-6665
US

IV. Provider business mailing address

364 MINAHEN ST
NAPA CA
94559-4435
US

V. Phone/Fax

Practice location:
  • Phone: 800-801-9833
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: