Provider Demographics
NPI:1922194307
Name:PINNER, ROBERT JOHNSTON (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JOHNSTON
Last Name:PINNER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11055 OAK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040-1228
Mailing Address - Country:US
Mailing Address - Phone:619-390-0812
Mailing Address - Fax:
Practice Address - Street 1:2375 NORTHSIDE DR STE 150
Practice Address - Street 2:MISSION HOME HEALTH
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-0002
Practice Address - Country:US
Practice Address - Phone:619-387-6315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4857101YA0400X
CO9870201041C0700X
CALCS235141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)