Healthcare Provider Details

I. General information

NPI: 1467785162
Provider Name (Legal Business Name): ROBIN DAWN ENGELMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2009
Last Update Date: 09/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2118 WILSHIRE BLVD # 192
SANTA MONICA CA
90403-5704
US

IV. Provider business mailing address

2118 WILSHIRE BLVD # 192
SANTA MONICA CA
90403-5704
US

V. Phone/Fax

Practice location:
  • Phone: 310-383-0420
  • Fax:
Mailing address:
  • Phone: 310-383-0420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPSY20019
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY20019
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY20019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: