Provider Demographics
NPI:1538868609
Name:NAZARIAN, ROBIN JANE (MA)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:JANE
Last Name:NAZARIAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:JANE
Other - Last Name:WAKELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:459 FULTON ST STE 107
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4364
Mailing Address - Country:US
Mailing Address - Phone:415-656-8327
Mailing Address - Fax:
Practice Address - Street 1:459 FULTON ST STE 107
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4364
Practice Address - Country:US
Practice Address - Phone:415-656-8327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA150520106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist