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NPI Code Detail

MEDICARE: ROBIN THACKER AMFT

MEDICARE: ROBIN THACKER AMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist158899CA

General Provider Information

NPI Number : 1386590412
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBIN THACKER AMFT
Provider Business Mailing Address
First Line : 3455 PERCY ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90023-1716
Country : US
Telephone Number : 323-268-2100
Fax Number :
Provider Business Practice Location Address
First Line : 3455 PERCY ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90023-1716
Country : US
Telephone Number : 323-268-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2026
Last Update Date : 03/10/2026

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Directions to “ ROBIN THACKER AMFT” Practice Location

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