Provider Demographics
NPI:1598897969
Name:MOTEN, ROBIN ELAINE (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:ELAINE
Last Name:MOTEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3741 STOCKER ST
Mailing Address - Street 2:207
Mailing Address - City:VIEW PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90008-5109
Mailing Address - Country:US
Mailing Address - Phone:323-596-2480
Mailing Address - Fax:323-596-2487
Practice Address - Street 1:3741 STOCKER ST
Practice Address - Street 2:207
Practice Address - City:VIEW PARK
Practice Address - State:CA
Practice Address - Zip Code:90008-5109
Practice Address - Country:US
Practice Address - Phone:323-596-2480
Practice Address - Fax:323-596-2487
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS280061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical