Healthcare Provider Details

I. General information

NPI: 1588330013
Provider Name (Legal Business Name): ALICIA MARIE ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2021
Last Update Date: 12/09/2025
Certification Date: 08/16/2021
Deactivation Date: 10/29/2025
Reactivation Date: 12/09/2025

III. Provider practice location address

2 COMPUTER DR W
ALBANY NY
12205-1639
US

IV. Provider business mailing address

1055 E COLORADO BLVD
PASADENA CA
91106-2327
US

V. Phone/Fax

Practice location:
  • Phone: 818-241-6780
  • Fax:
Mailing address:
  • Phone: 818-241-6853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: