Provider Demographics
NPI:1962567495
Name:CIAFONE, ROBIN L (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:L
Last Name:CIAFONE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 VENTURE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3340
Mailing Address - Country:US
Mailing Address - Phone:949-302-9654
Mailing Address - Fax:949-753-8899
Practice Address - Street 1:6 VENTURE
Practice Address - Street 2:SUITE 350
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3340
Practice Address - Country:US
Practice Address - Phone:949-302-9654
Practice Address - Fax:949-753-8899
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17741103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical