Provider Demographics
NPI:1124228820
Name:KLEIN-ROBUCK, BARBARA LEE (MS, RN)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LEE
Last Name:KLEIN-ROBUCK
Suffix:
Gender:F
Credentials:MS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27703 ORTEGA HWY SPC 39
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-1958
Mailing Address - Country:US
Mailing Address - Phone:949-493-2534
Mailing Address - Fax:949-240-1067
Practice Address - Street 1:27703 ORTEGA HWY SPC 39
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-1958
Practice Address - Country:US
Practice Address - Phone:949-493-2534
Practice Address - Fax:949-240-1067
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA195225171M00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174400000XOther Service ProvidersSpecialist