Basic Information
| Provider Information | |||||||||
| NPI: | 1598089492 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEVINE | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D., BCBA-D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 268 BUSH ST | ||||||||
| Address2: | SUITE 3039 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941043503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883623970 | ||||||||
| FaxNumber: | 5088827687 | ||||||||
| Practice Location | |||||||||
| Address1: | 268 BUSH ST | ||||||||
| Address2: | SUITE 3039 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941043503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883623970 | ||||||||
| FaxNumber: | 5088827687 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2010 | ||||||||
| LastUpdateDate: | 11/01/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PSY 25972 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103K00000X | 1-09-6462 | CA | N | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.