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General NPI Number Information
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NPI Number | 1316463748
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Entity Type | Individual
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Provider Name | JASMYNNE-SHAYE ROBBINS
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Gender | Female
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 5630 VENICE BLVD STE 751
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City | LOS ANGELES
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State | CA
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Zip | 90019-5127
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Country | US
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Telephone | 323-317-7272
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Fax | 877-940-3126
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Provider Business Mailing Address
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Address Line | 5630 VENICE BLVD STE 751
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City | LOS ANGELES
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State | CA
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Zip | 90019-5127
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Country | US
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Telephone | 323-317-7272
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Fax | 877-940-3126
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35089
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License Number State | CA
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