Provider Demographics
NPI:1417657347
Name:ROBINSON, CHIMEON CHANTA
Entity Type:Individual
Prefix:
First Name:CHIMEON
Middle Name:CHANTA
Last Name:ROBINSON
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 1:424 ACACIA DR
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-6337
Mailing Address - Country:US
Mailing Address - Phone:925-207-1254
Mailing Address - Fax:
Practice Address - Street 1:424 ACACIA DR
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-6337
Practice Address - Country:US
Practice Address - Phone:925-207-1254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician