Provider Demographics
NPI:1013139518
Name:ROBY, CORRINE ANN (LAC)
Entity Type:Individual
Prefix:
First Name:CORRINE
Middle Name:ANN
Last Name:ROBY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:357 N ACACIA AVE
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1107
Mailing Address - Country:US
Mailing Address - Phone:858-245-6929
Mailing Address - Fax:760-632-7730
Practice Address - Street 1:2210 ENCINITAS BLVD
Practice Address - Street 2:STE.E.
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4358
Practice Address - Country:US
Practice Address - Phone:760-632-7728
Practice Address - Fax:760-632-7730
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5977171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist