Provider Demographics
NPI:1114207131
Name:PAULSON, ROBIN D (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:D
Last Name:PAULSON
Suffix:
Gender:F
Credentials:LMFT
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 1472
Mailing Address - Street 2:
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-1472
Mailing Address - Country:US
Mailing Address - Phone:951-473-6118
Mailing Address - Fax:
Practice Address - Street 1:30755 AULD RD STE B
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2581
Practice Address - Country:US
Practice Address - Phone:951-696-3112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-22
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC46994106H00000X
CALMFT46994106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist