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General NPI Number Information
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NPI Number | 1770836603
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Entity Type | Individual
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Provider Name | ROBYN CANNON PEARL PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/16/2012
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 1516 OAK ST SUITE 313
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City | ALAMEDA
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State | CA
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Zip | 94501-2947
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Country | US
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Telephone | 415-322-0357
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 322
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City | KENTFIELD
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State | CA
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Zip | 94914
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Country | US
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Telephone | 415-322-0357
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 25174
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License Number State | CA
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