Provider Demographics
NPI:1811786643
Name:ROBINSON, MARIVIC SABINO
Entity type:Individual
Prefix:MRS
First Name:MARIVIC
Middle Name:SABINO
Last Name:ROBINSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MAREBLU STE 340
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3068
Mailing Address - Country:US
Mailing Address - Phone:949-831-5900
Mailing Address - Fax:949-831-1782
Practice Address - Street 1:15 MAREBLU STE 340
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3068
Practice Address - Country:US
Practice Address - Phone:949-831-5900
Practice Address - Fax:949-831-1782
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95034990363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology