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General NPI Number Information
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NPI Number | 1265261416
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Entity Type | Individual
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Provider Name | ROBENSON DORVIL MA
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Gender | Male
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Dates
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Enumeration Date | 07/27/2024
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 20695 S WESTERN AVE STE 132
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City | TORRANCE
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State | CA
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Zip | 90501-1834
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Country | US
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Telephone | 424-271-7414
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Fax |
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Provider Business Mailing Address
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Address Line | 14800 CHADRON AVE APT 9
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City | GARDENA
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State | CA
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Zip | 90249-3575
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Country | US
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Telephone | 184-256-0718
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT128092
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License Number State | CA
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