Provider Demographics
NPI:1710059712
Name:ROBERT J BUDIN
Entity Type:Organization
Organization Name:ROBERT J BUDIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUDIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA MFT
Authorized Official - Phone:714-639-9400
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM12133106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty