Provider Demographics
NPI:1073861738
Name:ROBINSON, REBECCA DELORES (LVN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:DELORES
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4281 KATELLA AVENUE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720
Mailing Address - Country:US
Mailing Address - Phone:714-503-6850
Mailing Address - Fax:562-467-5553
Practice Address - Street 1:4281 KATELLA AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3500
Practice Address - Country:US
Practice Address - Phone:714-503-6850
Practice Address - Fax:562-467-5553
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health