Provider Demographics
NPI:1992826515
Name:BOBENRIETH, PAULINA MARIA (RN, PHN, MPH)
Entity Type:Individual
Prefix:MS
First Name:PAULINA
Middle Name:MARIA
Last Name:BOBENRIETH
Suffix:
Gender:F
Credentials:RN, PHN, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 OXFORD ST
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-7111
Mailing Address - Country:US
Mailing Address - Phone:619-409-3128
Mailing Address - Fax:619-409-3110
Practice Address - Street 1:690 OXFORD ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-7111
Practice Address - Country:US
Practice Address - Phone:619-409-3128
Practice Address - Fax:619-409-3110
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA460199163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse