MEDICARE: MRS. MARIVIC SABINO ROBINSON

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
1	363LG0600X	Gerontology Nurse Practitioner	95034990	CA

General Provider Information

NPI Number	:	1811786643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIVIC SABINO ROBINSON

Provider Business Mailing Address
First Line	:	15 MAREBLU STE 340
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-3068
Country	:	US
Telephone Number	:	949-831-5900
Fax Number	:	949-831-1782

Provider Business Practice Location Address
First Line	:	15 MAREBLU STE 340
Second Line	:
City	:	ALISO VIEJO
State	:	CA
Zip	:	92656-3068
Country	:	US
Telephone Number	:	949-831-5900
Fax Number	:	949-831-1782

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2025
Last Update Date	:	05/06/2025

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