Healthcare Provider Details

I. General information

NPI: 1629402466
Provider Name (Legal Business Name): ANNA ROBERTSON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNA MESHCHERYAKOVA

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 ESPLANADE
CHICO CA
95926-3310
US

IV. Provider business mailing address

1110 SHUMARD OAK WAY
CHICO CA
95928-6694
US

V. Phone/Fax

Practice location:
  • Phone: 530-332-2716
  • Fax:
Mailing address:
  • Phone: 530-215-5659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A13679
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: