Healthcare Provider Details

I. General information

NPI: 1598897969
Provider Name (Legal Business Name): ROBIN ELAINE MOTEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3741 STOCKER ST 207
VIEW PARK CA
90008-5109
US

IV. Provider business mailing address

3741 STOCKER ST 207
VIEW PARK CA
90008-5109
US

V. Phone/Fax

Practice location:
  • Phone: 323-596-2480
  • Fax: 323-596-2487
Mailing address:
  • Phone: 323-596-2480
  • Fax: 323-596-2487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS28006
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: