Provider Demographics
NPI:1114256690
Name:ORBE, KERIN (DO)
Entity Type:Individual
Prefix:DR
First Name:KERIN
Middle Name:
Last Name:ORBE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KERIN
Other - Middle Name:
Other - Last Name:ORBE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:13288 DERON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2512
Mailing Address - Country:US
Mailing Address - Phone:917-538-2068
Mailing Address - Fax:
Practice Address - Street 1:248 LANDIS AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-2609
Practice Address - Country:US
Practice Address - Phone:619-515-2338
Practice Address - Fax:619-600-4454
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2648862084P0800X
CT542762084P0800X
CA20A172252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03579971Medicaid