=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932308301
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DENISE H ROBINSON LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/16/2007
-----------------------------------------------------
Last Update Date | 02/26/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6615 E PCH #190
-----------------------------------------------------
City | LONG BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90803
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-537-2646
-----------------------------------------------------
Fax | 562-621-0794
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6615 E PCH #190
-----------------------------------------------------
City | LONG BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90803
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-537-2646
-----------------------------------------------------
Fax | 562-621-0794
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | LCS21964
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------