Provider Demographics
NPI:1083495246
Name:SPOTTEN, ROBYN (AMFT)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:SPOTTEN
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:CRESTLINE
Mailing Address - State:CA
Mailing Address - Zip Code:92325-0497
Mailing Address - Country:US
Mailing Address - Phone:626-826-3275
Mailing Address - Fax:
Practice Address - Street 1:1174 NEVADA ST STE 210
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2893
Practice Address - Country:US
Practice Address - Phone:909-255-1250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA127785106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist