Provider Demographics
NPI:1790404606
Name:MATHIS, ROBIN ALEXIS (RN)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:ALEXIS
Last Name:MATHIS
Suffix:
Gender:F
Credentials:RN
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4630 CLOYNE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-7778
Mailing Address - Country:US
Mailing Address - Phone:805-814-2205
Mailing Address - Fax:
Practice Address - Street 1:2130 N VENTURA RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2246
Practice Address - Country:US
Practice Address - Phone:510-317-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95275583163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent