Provider Demographics
NPI:1174734867
Name:DECK, ROBIN L
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:DECK
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 1:1804 VINE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-1445
Mailing Address - Country:US
Mailing Address - Phone:805-928-2362
Mailing Address - Fax:
Practice Address - Street 1:2320 THOMPSON WAY
Practice Address - Street 2:SUITE D
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-1067
Practice Address - Country:US
Practice Address - Phone:805-739-1512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)