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General NPI Number Information
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NPI Number | 1932828860
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Entity Type | Individual
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Provider Name | ROBIN RACHELLE LONDON
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Gender | Female
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 4251 S HIGUERA ST STE 300
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-7741
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Country | US
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Telephone | 805-703-3709
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Fax |
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Provider Business Mailing Address
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Address Line | 4251 S HIGUERA ST STE 300
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-7741
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Country | US
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Telephone | 805-703-3709
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APCC10873
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 10-198
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT129590
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License Number State | CA
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