Provider Demographics
NPI:1659401479
Name:ROBINSON, TAMARA EVE (MA)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:EVE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5617 WOODMAN AVE
Mailing Address - Street 2:#102
Mailing Address - City:VALLEY GLEN
Mailing Address - State:CA
Mailing Address - Zip Code:91401-4730
Mailing Address - Country:US
Mailing Address - Phone:818-730-8007
Mailing Address - Fax:818-988-8269
Practice Address - Street 1:15720 VENTURA BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2914
Practice Address - Country:US
Practice Address - Phone:818-730-8007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45037106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist