Provider Demographics
NPI:1639531742
Name:BUDIN, ROBERT J JR (MFT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:BUDIN
Suffix:JR
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 E KATELLA AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5008
Mailing Address - Country:US
Mailing Address - Phone:714-639-9400
Mailing Address - Fax:714-771-2980
Practice Address - Street 1:1500 E KATELLA AVE
Practice Address - Street 2:SUITE H
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-5008
Practice Address - Country:US
Practice Address - Phone:714-639-9400
Practice Address - Fax:714-771-2980
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM12133106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist