Provider Demographics
NPI:1417273954
Name:AMSDEN, ROBIN THERESA
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:THERESA
Last Name:AMSDEN
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 1:1010 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-1540
Mailing Address - Country:US
Mailing Address - Phone:619-286-4600
Mailing Address - Fax:619-286-0060
Practice Address - Street 1:4974 EL CAJON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-4677
Practice Address - Country:US
Practice Address - Phone:619-286-4600
Practice Address - Fax:619-286-0060
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)