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NPI 1306048657

NPI 1306048657 : TAMBRA ROBINSON-MOLA ACSW, MSW : STOCKTON, CA

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General NPI Number Information
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    NPI Number           |    1306048657
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    Entity Type          |    Individual 
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    Provider Name        |    TAMBRA ROBINSON-MOLA ACSW, MSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/31/2007
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    Last Update Date     |    02/19/2025
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Provider Practice Location Address
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    Address Line         |    1803 W MARCH LN STE C 
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    City                 |    STOCKTON
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    State                |    CA
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    Zip                  |    95207-6414
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    Country              |    US
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    Telephone            |    916-364-8395
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1803 W MARCH LN STE C 
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    City                 |    STOCKTON
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    State                |    CA
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    Zip                  |    95207-6414
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    Country              |    US
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    Telephone            |    916-364-8395
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    29753
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    126311
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    License Number State |    CA
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