Provider Demographics
NPI:1295381325
Name:DEVEREAUX-CARTER, ROBINAE C
Entity Type:Individual
Prefix:
First Name:ROBINAE
Middle Name:C
Last Name:DEVEREAUX-CARTER
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 1:7500 SAINT PATRICK WAY APT 219
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-4392
Mailing Address - Country:US
Mailing Address - Phone:510-648-5661
Mailing Address - Fax:
Practice Address - Street 1:7500 SAINT PATRICK WAY APT 219
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-4392
Practice Address - Country:US
Practice Address - Phone:510-648-5661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst