Provider Demographics
NPI:1154598597
Name:ROBINSON, JESSICA AMBER (MFT)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:AMBER
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E SAN MARCOS BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2986
Mailing Address - Country:US
Mailing Address - Phone:760-271-3170
Mailing Address - Fax:760-510-5901
Practice Address - Street 1:100 E SAN MARCOS BLVD STE 400
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-2988
Practice Address - Country:US
Practice Address - Phone:760-271-3170
Practice Address - Fax:866-561-3747
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 51229106H00000X
101YM0800X
CAIMF 60971106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health