Provider Demographics
NPI:1093032609
Name:ROBLES, KRISTINA LYNN (RD)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:LYNN
Last Name:ROBLES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MRS
Other - First Name:KRISTINA
Other - Middle Name:LYNN
Other - Last Name:HOOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:3922 127TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1276
Mailing Address - Country:US
Mailing Address - Phone:949-315-9085
Mailing Address - Fax:
Practice Address - Street 1:3922 127TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1276
Practice Address - Country:US
Practice Address - Phone:949-315-9085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1004021133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered