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NPI Code Detail

MEDICARE: JEANIE CAMERON ROBB

MEDICARE: JEANIE CAMERON 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
1101Y00000XCounselor

General Provider Information

NPI Number : 1750529061
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANIE CAMERON ROBB
Provider Business Mailing Address
First Line : 2275 ARLINGTON DR
Second Line :
City : SAN LEANDRO
State : CA
Zip : 94578-1132
Country : US
Telephone Number : 510-656-6411
Fax Number :
Provider Business Practice Location Address
First Line : 42875 GATEWOOD ST
Second Line :
City : FREMONT
State : CA
Zip : 94538-4131
Country : US
Telephone Number : 510-656-6411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2009
Last Update Date : 01/23/2009

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