Healthcare Provider Details

I. General information

NPI: 1083534051
Provider Name (Legal Business Name): ORSON ROBERTS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3883 ADDYS LN
OROVILLE CA
95965-9195
US

IV. Provider business mailing address

3883 ADDYS LN
OROVILLE CA
95965-9195
US

V. Phone/Fax

Practice location:
  • Phone: 858-344-5064
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040635
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: