Provider Demographics
NPI:1093928186
Name:ROBSON, JEANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:
Last Name:ROBSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JEANNE
Other - Middle Name:
Other - Last Name:HERSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:610 SANTA MONICA BLVD
Mailing Address - Street 2:208
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401
Mailing Address - Country:US
Mailing Address - Phone:310-395-8131
Mailing Address - Fax:
Practice Address - Street 1:610 SANTA MONICA BLVD
Practice Address - Street 2:208
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401
Practice Address - Country:US
Practice Address - Phone:310-395-8131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8071103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00PL80710OtherBLUE SHIELD OF CALIFORNIA