Provider Demographics
NPI:1437438447
Name:DAVIDSON, ROBIN KRISTINA (RN, LAC)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:KRISTINA
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:RN, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1474
Mailing Address - Street 2:
Mailing Address - City:COBB
Mailing Address - State:CA
Mailing Address - Zip Code:95426-1474
Mailing Address - Country:US
Mailing Address - Phone:707-621-0394
Mailing Address - Fax:
Practice Address - Street 1:11224 PINE SUMMIT DRIVE
Practice Address - Street 2:
Practice Address - City:COBB
Practice Address - State:CA
Practice Address - Zip Code:95426-1474
Practice Address - Country:US
Practice Address - Phone:707-621-0394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA290314163WC0200X
CA4934171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine