Provider Demographics
NPI:1558544643
Name:ROBINSON, MARCIA RENEE
Entity Type:Individual
Prefix:MISS
First Name:MARCIA
Middle Name:RENEE
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 1:1180 3RD AVE
Mailing Address - Street 2:C-3
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-3139
Mailing Address - Country:US
Mailing Address - Phone:619-422-3918
Mailing Address - Fax:619-426-2359
Practice Address - Street 1:1180 3RD AVE
Practice Address - Street 2:C-3
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-3139
Practice Address - Country:US
Practice Address - Phone:619-422-3918
Practice Address - Fax:619-426-2359
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)