Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY14286 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY14286 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY14286 | CA |
NPI | 1063550267 |
---|---|
Provider Name | Dr. Sophia Anastasia Robinson |
First Address | Yorba Linda, CA 92886-1857 |
Second Address | Yorba Linda, CA 92886-1857 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 14/11/2012 |