Provider Demographics
NPI:1417563859
Name:HARNEY, ROBIN ALYSSA
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:ALYSSA
Last Name:HARNEY
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 1:12501 SEAL BEACH BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-8815
Mailing Address - Country:US
Mailing Address - Phone:714-226-9770
Mailing Address - Fax:
Practice Address - Street 1:12501 SEAL BEACH BLVD STE 230
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-8815
Practice Address - Country:US
Practice Address - Phone:714-226-9770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95020986363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health