Provider Demographics
NPI:1558595454
Name:LIVINGSTONE, ROBIE GROVE (MPT)
Entity Type:Individual
Prefix:
First Name:ROBIE
Middle Name:GROVE
Last Name:LIVINGSTONE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 PRINCETON RD
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-5217
Mailing Address - Country:US
Mailing Address - Phone:650-330-0282
Mailing Address - Fax:
Practice Address - Street 1:253 PRINCETON RD
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-5217
Practice Address - Country:US
Practice Address - Phone:650-330-0282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24478225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist