Provider Demographics
NPI:1881389245
Name:ROBINSON, DIANE (MS, CNS CANDIDATE)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS, CNS CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 JULES DR
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94947-2015
Mailing Address - Country:US
Mailing Address - Phone:415-846-1891
Mailing Address - Fax:
Practice Address - Street 1:22 JULES DR
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-2015
Practice Address - Country:US
Practice Address - Phone:415-846-1891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No171400000XOther Service ProvidersHealth & Wellness Coach