Provider Demographics
NPI:1609091651
Name:AULGUR, ROBIN JOY (MFT - INTERN)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:JOY
Last Name:AULGUR
Suffix:
Gender:F
Credentials:MFT - INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 W IMPERIAL AVE
Mailing Address - Street 2:UNIT 2
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-2085
Mailing Address - Country:US
Mailing Address - Phone:310-322-1126
Mailing Address - Fax:
Practice Address - Street 1:360 N SEPULVEDA BLVD
Practice Address - Street 2:SUITE 2075
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-4460
Practice Address - Country:US
Practice Address - Phone:310-414-2090
Practice Address - Fax:310-414-2096
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47724106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist