Provider Demographics
NPI:1518125251
Name:KROTZ, ROBIN FITZGERALD (MFC34546)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:FITZGERALD
Last Name:KROTZ
Suffix:
Gender:F
Credentials:MFC34546
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:FITZGERALD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:205 AVENUE I
Mailing Address - Street 2:SUITE 20
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277
Mailing Address - Country:US
Mailing Address - Phone:310-316-5606
Mailing Address - Fax:
Practice Address - Street 1:205 AVENUE I
Practice Address - Street 2:SUITE 20
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277
Practice Address - Country:US
Practice Address - Phone:310-316-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34546106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist