Provider Demographics
NPI:1740336304
Name:CREIGHTON, ROBIN VALERIE CABALLA (PA-C)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:VALERIE CABALLA
Last Name:CREIGHTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:C5 PMR DEPARTMENT
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:DEPARTMENT OF C5
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1098
Practice Address - Country:US
Practice Address - Phone:619-531-1404
Practice Address - Fax:619-532-9023
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2023-08-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA 17147363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical