Healthcare Provider Details

I. General information

NPI: 1982444741
Provider Name (Legal Business Name): LA RAE ROBIN BANKS DRPH, MBA-HM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 04/10/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 MARIA LN STE 300
WALNUT CREEK CA
94596-5314
US

IV. Provider business mailing address

1460 MARIA LN STE 300
WALNUT CREEK CA
94596-5314
US

V. Phone/Fax

Practice location:
  • Phone: 925-433-8877
  • Fax: 925-533-4758
Mailing address:
  • Phone: 925-433-8877
  • Fax: 925-553-4758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: