Provider Demographics
NPI:1568936854
Name:ROBINS, PATRICE S (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICE
Middle Name:S
Last Name:ROBINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 HEAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-3725
Mailing Address - Country:US
Mailing Address - Phone:818-231-1115
Mailing Address - Fax:
Practice Address - Street 1:530 WILSHIRE BLVD STE 306
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1426
Practice Address - Country:US
Practice Address - Phone:818-231-1115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-19
Last Update Date:2019-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16854103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty