Healthcare Provider Details

I. General information

NPI: 1124952239
Provider Name (Legal Business Name): ROBERT L LANCIONE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10911 SABRE HILL DR UNIT 357
SAN DIEGO CA
92128-4183
US

IV. Provider business mailing address

10911 SABRE HILL DR UNIT 357
SAN DIEGO CA
92128-4183
US

V. Phone/Fax

Practice location:
  • Phone: 760-705-0654
  • Fax:
Mailing address:
  • Phone: 760-705-0654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: