Provider Demographics
NPI:1376750885
Name:FURNER, ROBIN BROOKE
Entity Type:Individual
Prefix:MISS
First Name:ROBIN
Middle Name:BROOKE
Last Name:FURNER
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 1:4000 BROADWAY STE 1
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5670
Mailing Address - Country:US
Mailing Address - Phone:510-463-1465
Mailing Address - Fax:
Practice Address - Street 1:4000 BROADWAY STE 1
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5670
Practice Address - Country:US
Practice Address - Phone:510-463-1465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44794106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist