Provider Demographics
NPI:1982042271
Name:BUNYAN, ROBIN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ROBIN
Middle Name:
Last Name:BUNYAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3608 CUMBRE CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-2770
Mailing Address - Country:US
Mailing Address - Phone:661-330-6565
Mailing Address - Fax:
Practice Address - Street 1:3608 CUMBRE CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-2770
Practice Address - Country:US
Practice Address - Phone:661-330-6565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical