Provider Demographics
NPI:1538476965
Name:ORCUTT, ROBIN MARIE
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:MARIE
Last Name:ORCUTT
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 1:11133 AQUA VISTA ST
Mailing Address - Street 2:APARTMENT 211
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91602-3174
Mailing Address - Country:US
Mailing Address - Phone:310-310-9893
Mailing Address - Fax:
Practice Address - Street 1:11133 AQUA VISTA ST
Practice Address - Street 2:APARTMENT 211
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91602-3174
Practice Address - Country:US
Practice Address - Phone:310-310-9893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26707101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health