Provider Demographics
NPI:1093926982
Name:ROBINSON, BRENDA RENAE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:RENAE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:BRENDA
Other - Middle Name:RENAE
Other - Last Name:HOLTZEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:25470 MEDICAL CENTER DR
Mailing Address - Street 2:STE 201
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4901
Mailing Address - Country:US
Mailing Address - Phone:951-698-4433
Mailing Address - Fax:951-461-8790
Practice Address - Street 1:28780 SINGLE OAK DR
Practice Address - Street 2:SUITE 160
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3625
Practice Address - Country:US
Practice Address - Phone:951-676-4193
Practice Address - Fax:951-719-1469
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16834363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant