MEDICARE: ROBIN JONES RADT

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	R1602340325	CA

General Provider Information

NPI Number	:	1720949670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN JONES RADT

Provider Business Mailing Address
First Line	:	6557 COSTELLO AVE
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-1506
Country	:	US
Telephone Number	:	805-216-9625
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 N EL MOLINO AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-1805
Country	:	US
Telephone Number	:	626-792-2770
Fax Number	:

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

Provider Enumeration Date	:	11/20/2025
Last Update Date	:	12/08/2025

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