Healthcare Provider Details

I. General information

NPI: 1891843355
Provider Name (Legal Business Name): ROBIN MORGAN PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ROBIN WENNERBERG PSY.D.

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 10/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 AVENUE B APT 1012
SAN ANTONIO TX
78215-2300
US

IV. Provider business mailing address

1201 AVENUE B APT 1012
SAN ANTONIO TX
78215-2300
US

V. Phone/Fax

Practice location:
  • Phone: 323-481-3389
  • Fax:
Mailing address:
  • Phone: 323-481-3389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4368
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number36602
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number36602
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: