Provider Demographics
NPI:1265846877
Name:MCCALL, ROBIN (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:MCCALL
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 1:2459 DUBLIN WAY
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-4143
Mailing Address - Country:US
Mailing Address - Phone:909-498-6655
Mailing Address - Fax:951-867-3840
Practice Address - Street 1:6296 RIVER CREST DR STE K
Practice Address - Street 2:6296 RIVER CREST DRIVE #K
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-0738
Practice Address - Country:US
Practice Address - Phone:951-867-3800
Practice Address - Fax:951-867-3840
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293561041C0700X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator