Provider Demographics
NPI:1487630141
Name:HANSEN, ROBIN L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:L
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 50TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2308
Mailing Address - Country:US
Mailing Address - Phone:916-703-0235
Mailing Address - Fax:916-703-0243
Practice Address - Street 1:2825 50TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2308
Practice Address - Country:US
Practice Address - Phone:916-703-0235
Practice Address - Fax:916-703-0243
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0384432080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG038443OtherSTATE LICENSE
CAAH1811012OtherSTATE CONTROLLED SUBST NO
00G038443OtherMEDI CAL#
CAG038443OtherSTATE LICENSE