Healthcare Provider Details

I. General information

NPI: 1346164696
Provider Name (Legal Business Name): REQUAL NEVAJEAN ROBINSON MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1698 HILTON ST
SEASIDE CA
93955-4433
US

IV. Provider business mailing address

1698 HILTON ST
SEASIDE CA
93955-4433
US

V. Phone/Fax

Practice location:
  • Phone: 831-521-3102
  • Fax:
Mailing address:
  • Phone: 831-521-3102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: