Provider Demographics
NPI:1750568721
Name:WEMPE, ROBIN (PA)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:WEMPE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 22210
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94623-2210
Mailing Address - Country:US
Mailing Address - Phone:925-676-0505
Mailing Address - Fax:
Practice Address - Street 1:220 HOSPITAL DRIVE
Practice Address - Street 2:NORTH VALLEJO
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2577
Practice Address - Country:US
Practice Address - Phone:707-641-1900
Practice Address - Fax:707-554-2294
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16062363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant