Provider Demographics
NPI:1518778448
Name:ROBINSON, TANISHA (DSW, LMFT)
Entity type:Individual
Prefix:
First Name:TANISHA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DSW, LMFT
Other - Prefix:
Other - First Name:TANISHA
Other - Middle Name:
Other - Last Name:MELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1420 RAVENSWOOD LN
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-5541
Mailing Address - Country:US
Mailing Address - Phone:562-307-6129
Mailing Address - Fax:
Practice Address - Street 1:1307 W 6TH ST STE 108
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-1642
Practice Address - Country:US
Practice Address - Phone:888-662-9378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT152177101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health