Provider Demographics
NPI:1275039729
Name:ROBERTSON, ANGELA N
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:N
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 GRIDLEY DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-1930
Mailing Address - Country:US
Mailing Address - Phone:510-932-9392
Mailing Address - Fax:
Practice Address - Street 1:1017 GRIDLEY DR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-1930
Practice Address - Country:US
Practice Address - Phone:510-932-9392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician