Provider Demographics
NPI:1104003078
Name:THOMAS-ROBINSON, SHELLEY (LCSW)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:
Last Name:THOMAS-ROBINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23470 OLIVE WOOD PLAZA DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-5264
Mailing Address - Country:US
Mailing Address - Phone:951-242-6039
Mailing Address - Fax:
Practice Address - Street 1:23470 OLIVE WOOD PLAZA DR
Practice Address - Street 2:SUITE 140
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-5264
Practice Address - Country:US
Practice Address - Phone:951-242-6039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2009-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW237351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical