MEDICARE: ANDREA ROSE ROBINSON LCSW

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	1041C0700X	Clinical Social Worker	126700	CA
2	1041S0200X	School Social Worker	230208008	CA

General Provider Information

NPI Number	:	1912671942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA ROSE ROBINSON LCSW

Provider Business Mailing Address
First Line	:	2810 NUGGET AVE
Second Line	:
City	:	LAKE ISABELLA
State	:	CA
Zip	:	93240-9494
Country	:	US
Telephone Number	:	760-370-4646
Fax Number	:

Provider Business Practice Location Address
First Line	:	2810 NUGGET AVE
Second Line	:
City	:	LAKE ISABELLA
State	:	CA
Zip	:	93240-9494
Country	:	US
Telephone Number	:	760-379-4646
Fax Number	:

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

Provider Enumeration Date	:	08/03/2021
Last Update Date	:	04/28/2026

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