Provider Demographics
NPI:1477015071
Name:HASKINS, ROBIN JEWEL (CADC-CAS)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:JEWEL
Last Name:HASKINS
Suffix:
Gender:F
Credentials:CADC-CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 W MINER ST
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-2845
Mailing Address - Country:US
Mailing Address - Phone:562-341-1359
Mailing Address - Fax:
Practice Address - Street 1:9024 SNIKTAW LN
Practice Address - Street 2:
Practice Address - City:FORT JONES
Practice Address - State:CA
Practice Address - Zip Code:96032-9408
Practice Address - Country:US
Practice Address - Phone:530-468-4470
Practice Address - Fax:530-468-4478
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC19371214101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1306062419OtherQUARTZ VALLEY INDIAN RESERVATION NPI NUMBER