Healthcare Provider Details

I. General information

NPI: 1295639037
Provider Name (Legal Business Name): EMMA COLE ROBERTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 CITRACADO PKWY STE 100
ESCONDIDO CA
92029-4151
US

IV. Provider business mailing address

1847 BLUE BONNET PL
ENCINITAS CA
92024-1963
US

V. Phone/Fax

Practice location:
  • Phone: 858-485-1111
  • Fax:
Mailing address:
  • Phone: 760-525-6499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4727902
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: