Provider Demographics
NPI:1326499518
Name:ROBINSON, SHILOH (SLP)
Entity Type:Individual
Prefix:
First Name:SHILOH
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9726 MONTE CARLO CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-7519
Mailing Address - Country:US
Mailing Address - Phone:919-332-2116
Mailing Address - Fax:
Practice Address - Street 1:3900 BIRCH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2209
Practice Address - Country:US
Practice Address - Phone:919-332-2116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22605235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist