Provider Demographics
NPI:1073383089
Name:MARTIN, ROBIN KATHERINE (MA)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:KATHERINE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27411 PAPAYA CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-5769
Mailing Address - Country:US
Mailing Address - Phone:661-670-6157
Mailing Address - Fax:
Practice Address - Street 1:27411 PAPAYA CT
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-5769
Practice Address - Country:US
Practice Address - Phone:661-670-6157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14319101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional