Provider Demographics
NPI:1255205852
Name:ROBINSON, JEKORA (CPSS)
Entity type:Individual
Prefix:
First Name:JEKORA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44620 VLY CTR WAY # 1218
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-6533
Mailing Address - Country:US
Mailing Address - Phone:310-946-3521
Mailing Address - Fax:
Practice Address - Street 1:44460 15TH ST E APT 1
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-3487
Practice Address - Country:US
Practice Address - Phone:424-261-3777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X, 251C00000X, 372600000X, 385H00000X
CA251B00000X, 175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No172V00000XOther Service ProvidersCommunity Health Worker
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No372600000XNursing Service Related ProvidersAdult Companion
No385H00000XRespite Care FacilityRespite Care