Provider Demographics
NPI:1679054928
Name:ROBINSON, TYEAUNA S
Entity type:Individual
Prefix:
First Name:TYEAUNA
Middle Name:S
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12367 CALLE ALBARA APT 2
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-4832
Mailing Address - Country:US
Mailing Address - Phone:619-517-5702
Mailing Address - Fax:
Practice Address - Street 1:1660 HOTEL CIR N STE 320
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-2807
Practice Address - Country:US
Practice Address - Phone:619-481-5200
Practice Address - Fax:619-481-5219
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health