Provider Demographics
NPI:1821828476
Name:ROBINSON, TERRY GARNETT JR
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:GARNETT
Last Name:ROBINSON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:TERAYLE
Other - Middle Name:
Other - Last Name:GARNETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:411 W ESPLANADE DR # 1052
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-1298
Mailing Address - Country:US
Mailing Address - Phone:820-888-9117
Mailing Address - Fax:
Practice Address - Street 1:411 W ESPLANADE DR # 1052
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-1298
Practice Address - Country:US
Practice Address - Phone:820-888-9117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty