Provider Demographics
NPI:1831362979
Name:ROBIE, TEHEA (LAC)
Entity type:Individual
Prefix:DR
First Name:TEHEA
Middle Name:
Last Name:ROBIE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:768 CONTRA COSTA AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-1937
Mailing Address - Country:US
Mailing Address - Phone:510-497-0874
Mailing Address - Fax:
Practice Address - Street 1:1941 JACKSON ST STE 13
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-4600
Practice Address - Country:US
Practice Address - Phone:510-497-0874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB7148916101YM0800X
CA17727171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health