Provider Demographics
NPI:1811105174
Name:ROBERTSON, URSULA (HHP)
Entity type:Individual
Prefix:MRS
First Name:URSULA
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 TAMPA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-2842
Mailing Address - Country:US
Mailing Address - Phone:619-301-2105
Mailing Address - Fax:619-644-1747
Practice Address - Street 1:2340 TAMPA AVE STE A
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-2842
Practice Address - Country:US
Practice Address - Phone:619-301-2105
Practice Address - Fax:619-644-1747
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist