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NPI Code Detail

MEDICARE: CHASE ADIYA ROBERTSON RN

MEDICARE: CHASE ADIYA ROBERTSON RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse95443991CA

General Provider Information

NPI Number : 1235088873
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHASE ADIYA ROBERTSON RN
Provider Business Mailing Address
First Line : 5832 BALMONT ST
Second Line :
City : LANCASTER
State : CA
Zip : 93536-5624
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1600 W AVENUE J
Second Line :
City : LANCASTER
State : CA
Zip : 93534-2814
Country : US
Telephone Number : 661-949-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2026
Last Update Date : 01/27/2026

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