Provider Demographics
NPI:1568970770
Name:ROBINSON, BRIANICA MONYA
Entity Type:Individual
Prefix:
First Name:BRIANICA
Middle Name:MONYA
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 1:1950 S SUNWEST LN STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92418-3248
Mailing Address - Country:US
Mailing Address - Phone:714-509-8481
Mailing Address - Fax:
Practice Address - Street 1:1950 S SUNWEST LN STE 200
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92418-4233
Practice Address - Country:US
Practice Address - Phone:909-252-4026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-22
Last Update Date:2022-07-06
Deactivation Date:2022-04-22
Deactivation Code:
Reactivation Date:2022-05-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor