Provider Demographics
NPI:1689093114
Name:ROBINSON, AMBERR L
Entity Type:Individual
Prefix:
First Name:AMBERR
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMBERR
Other - Middle Name:L
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:21089 FOREST GLEN RD
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93638-7846
Mailing Address - Country:US
Mailing Address - Phone:402-560-9579
Mailing Address - Fax:
Practice Address - Street 1:21089 FOREST GLEN RD
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-7846
Practice Address - Country:US
Practice Address - Phone:402-560-9579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-13
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30595103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist