Healthcare Provider Details

I. General information

NPI: 1437438447
Provider Name (Legal Business Name): ROBIN KRISTINA DAVIDSON RN, L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2011
Last Update Date: 08/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11224 PINE SUMMIT DRIVE
COBB CA
95426-1474
US

IV. Provider business mailing address

PO BOX 1474
COBB CA
95426-1474
US

V. Phone/Fax

Practice location:
  • Phone: 707-621-0394
  • Fax:
Mailing address:
  • Phone: 707-621-0394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number290314
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number4934
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: