MEDICARE: CAROLINA ROBB

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	M13514	CA
2	101YM0800X	Mental Health Counselor	M13514	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11486601	OTHER	CA	CAQH

General Provider Information

NPI Number	:	1649302605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINA ROBB

Provider Business Mailing Address
First Line	:	2647 INTERNATIONAL BLVD
Second Line	:	SUITE 412
City	:	OAKLAND
State	:	CA
Zip	:	94601-1537
Country	:	US
Telephone Number	:	510-532-5242
Fax Number	:	510-533-7918

Provider Business Practice Location Address
First Line	:	2647 INTERNATIONAL BLVD
Second Line	:	SUITE 412
City	:	OAKLAND
State	:	CA
Zip	:	94601-1537
Country	:	US
Telephone Number	:	510-532-5242
Fax Number	:	510-533-7918

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	09/11/2025

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Directions to “ CAROLINA ROBB ” Practice Location

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