Healthcare Provider Details

I. General information

NPI: 1609757350
Provider Name (Legal Business Name): ANDREW JACOB ROBERTSON AMFT#158068
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 CANOGA AVE STE 209
WOODLAND HILLS CA
91367-7794
US

IV. Provider business mailing address

15701 SHERMAN WAY UNIT 7049
VAN NUYS CA
91409-8605
US

V. Phone/Fax

Practice location:
  • Phone: 818-527-2743
  • Fax:
Mailing address:
  • Phone: 818-527-2743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: