Provider Demographics
NPI:1598274102
Name:ROBINSON, MICHAEL EVERETTE (ACSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:EVERETTE
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20953
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-3314
Mailing Address - Country:US
Mailing Address - Phone:510-258-4788
Mailing Address - Fax:
Practice Address - Street 1:7200 BANCROFT AVE STE 133
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2480
Practice Address - Country:US
Practice Address - Phone:510-553-8500
Practice Address - Fax:510-553-8550
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-26
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA909651041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health