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General NPI Number Information
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NPI Number | 1366651028
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Entity Type | Individual
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Provider Name | ROBIN COLLEEN WAND PSYD
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 2579 SAN PABLO AVE
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City | OAKLAND
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State | CA
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Zip | 94612-1159
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Country | US
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Telephone | 510-446-7103
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Fax | 510-832-0609
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Provider Business Mailing Address
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Address Line | 2579 SAN PABLO AVE
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City | OAKLAND
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State | CA
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Zip | 94612-1159
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Country | US
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Telephone | 510-292-9885
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY 17603
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | PSY 17603
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License Number State | CA
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