Healthcare Provider Details

I. General information

NPI: 1235166810
Provider Name (Legal Business Name): YASMIN CURAMENG ROBLES-GRAY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 01/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11888 BARTLETT AVE
ADELANTO CA
92301-1709
US

IV. Provider business mailing address

11888 BARTLETT AVE
ADELANTO CA
92301-1709
US

V. Phone/Fax

Practice location:
  • Phone: 760-530-9944
  • Fax:
Mailing address:
  • Phone: 760-780-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP14505
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: