Provider Demographics
NPI:1184628422
Name:ROBBINS, DIANE K (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:K
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16168 BEACH BLVD
Mailing Address - Street 2:STE 265
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3886
Mailing Address - Country:US
Mailing Address - Phone:714-843-0663
Mailing Address - Fax:
Practice Address - Street 1:16168 BEACH BLVD
Practice Address - Street 2:STE 265
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3886
Practice Address - Country:US
Practice Address - Phone:714-843-0663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14815103T00000X
CAMFC19668106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP14815Medicare PIN