Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | OT6446 | CA |
NPI | 1780105940 |
---|---|
Provider Name | Cindy Sue Robins |
First Address | San Jose, CA 95112-6312 |
Second Address | San Jose, CA 95112-6312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2017 |
Last Update Date | 28/06/2017 |