Provider Demographics
NPI:1790871887
Name:ROBBINS, KATHLEEN ANITA (MFT)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANITA
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W VISTA WY 407
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083
Mailing Address - Country:US
Mailing Address - Phone:760-758-1092
Mailing Address - Fax:760-758-8481
Practice Address - Street 1:550 W VISTA WAY STE 407
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-5714
Practice Address - Country:US
Practice Address - Phone:760-758-1092
Practice Address - Fax:760-758-8481
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34626106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist