Provider Demographics
NPI:1649873464
Name:ROBINSON, SUSAN (ASW)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 MONTEREY AVE
Mailing Address - Street 2:
Mailing Address - City:CAPITOLA
Mailing Address - State:CA
Mailing Address - Zip Code:95010-3618
Mailing Address - Country:US
Mailing Address - Phone:831-464-5630
Mailing Address - Fax:
Practice Address - Street 1:8005 WINKLE AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1149
Practice Address - Country:US
Practice Address - Phone:831-464-5670
Practice Address - Fax:831-476-5827
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YS0200X, 101YM0800X
CA121152104100000X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health