Provider Demographics
NPI:1093871592
Name:ROSIN, ROBYN CARRIE (RAS)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:CARRIE
Last Name:ROSIN
Suffix:
Gender:F
Credentials:RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6099 ROLAND DR.
Mailing Address - Street 2:P.O.BOX 384
Mailing Address - City:LUCERNE
Mailing Address - State:CA
Mailing Address - Zip Code:95458
Mailing Address - Country:US
Mailing Address - Phone:707-274-1454
Mailing Address - Fax:
Practice Address - Street 1:6302 THIRTEENTH AVENUE
Practice Address - Street 2:
Practice Address - City:LUCERNE
Practice Address - State:CA
Practice Address - Zip Code:95458
Practice Address - Country:US
Practice Address - Phone:707-274-9101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARO507101638101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)