Provider Demographics
NPI:1346767092
Name:ROBINSON, DANIEL ALLAN (RADT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALLAN
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:RADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36125 CREIGHTON AVE APT 1204
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-4503
Mailing Address - Country:US
Mailing Address - Phone:951-414-0088
Mailing Address - Fax:
Practice Address - Street 1:24885 WHITEWOOD RD STE 105
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2004
Practice Address - Country:US
Practice Address - Phone:951-698-8558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1249200417101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)