Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PSY5371 | CA |
N | 103T00000X | Psychologist | PSY5371 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | PSY5371 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY5371 | CA |
Y | 103G00000X | Clinical Psychologist | PSY5371 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY5371 | CA |
N | 103TC1900X | Counseling Psychologist | PSY5371 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY5371 | CA |
N | 103TF0000X | Family Psychologist | PSY5371 | CA |
N | 103TF0200X | Forensic Psychologist | PSY5371 | CA |
N | 103TH0004X | Health Psychologist | PSY5371 | CA |
N | 103TM1800X | Intellectual & Developmental Disabilities | PSY5371 | CA |
N | 103TS0200X | School Psychologist | PSY5371 | CA |
NPI | 1225269558 |
---|---|
Provider Name | Dr. Robin Schupp |
First Address | Laguna Hills, CA 92653-6100 |
Second Address | Aliso Viejo, CA 92656-5833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2009 |
Last Update Date | 04/08/2009 |