Provider Demographics
NPI:1932429206
Name:O'HEERON, ROBIN C (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:C
Last Name:O'HEERON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:C
Other - Last Name:O'HEERON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:21 TAMAL VISTA BLVD STE 224
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1127
Mailing Address - Country:US
Mailing Address - Phone:415-924-8489
Mailing Address - Fax:
Practice Address - Street 1:21 TAMAL VISTA BLVD
Practice Address - Street 2:STE 205
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1130
Practice Address - Country:US
Practice Address - Phone:415-924-8489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14413103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral