MEDICARE: SUSAN JANE ROBINETTE MFT

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	101YS0200X	School Counselor	250079431	CA
2	106H00000X	Marriage & Family Therapist	MFC 42326	CA

General Provider Information

NPI Number	:	1689879868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN JANE ROBINETTE MFT

Provider Business Mailing Address
First Line	:	1108 BISSELL AVE
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94801-3135
Country	:	US
Telephone Number	:	510-231-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	519 ESTUDILLO AVE STE N
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94577-4600
Country	:	US
Telephone Number	:	510-677-5347
Fax Number	:	510-352-4223

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

Provider Enumeration Date	:	06/18/2007
Last Update Date	:	06/03/2026

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