Provider Demographics
NPI:1013180504
Name:ROBSON-BORIS, DIANE KAREN (MFT)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:KAREN
Last Name:ROBSON-BORIS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 CORNELL ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1307
Mailing Address - Country:US
Mailing Address - Phone:650-561-3955
Mailing Address - Fax:
Practice Address - Street 1:2060 CORNELL ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1307
Practice Address - Country:US
Practice Address - Phone:650-561-3955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT37308106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist