Healthcare Provider Details

I. General information

NPI: 1790871887
Provider Name (Legal Business Name): KATHLEEN ANITA ROBBINS MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W VISTA WAY STE 407
VISTA CA
92083-5714
US

IV. Provider business mailing address

550 W VISTA WY 407
VISTA CA
92083
US

V. Phone/Fax

Practice location:
  • Phone: 760-758-1092
  • Fax: 760-758-8481
Mailing address:
  • Phone: 760-758-1092
  • Fax: 760-758-8481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC34626
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: