Provider Demographics
NPI:1982986352
Name:ROBERTSON, DORIS NG (LCSW, MPH)
Entity type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:NG
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:LCSW, MPH
Other - Prefix:MS
Other - First Name:DORIS
Other - Middle Name:WEI-CEE
Other - Last Name:NG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, MPH
Mailing Address - Street 1:1119 S CITRUS AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-1644
Mailing Address - Country:US
Mailing Address - Phone:310-701-6732
Mailing Address - Fax:
Practice Address - Street 1:1119 S CITRUS AVE APT 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-1644
Practice Address - Country:US
Practice Address - Phone:310-701-6732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA701281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health