Provider Demographics
NPI:1558486977
Name:ANDERSON, ROBIN MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:MARIE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 BARNES ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-3406
Mailing Address - Country:US
Mailing Address - Phone:760-966-3812
Mailing Address - Fax:
Practice Address - Street 1:104 BARNES ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-3406
Practice Address - Country:US
Practice Address - Phone:760-966-3812
Practice Address - Fax:760-967-4644
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA581245163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA163WC1500XMedicare UPIN