Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY25119 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY25119 | CA |
NPI | 1003932997 |
---|---|
Provider Name | Dr. Marissa A Robinson |
First Address | Fairfax, CA 94930-1906 |
Second Address | Fairfax, CA 94930-1906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 20/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9967 | CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER (01) | |
9967 | SFGH INTERNAL USE ONLY (01) |