Provider Information for 1912553231
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RHONDA C ROBERTSON
Sex: Female
NPI: 1912553231
Last Updated: 2020-01-23
Certification Date: 2020-01-23
Certification Date: 2020-01-23
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1912553231 | ||||||||
| Enumeration Date | 2019-08-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1622 4TH ST SANTA ROSA, CA 95404-4020 United States Phone: 707-978-8089 | Fax: | ||||||||
| Primary Practice Address | 1622 4TH ST SANTA ROSA, CA 95404-4020 United States Phone: 707-978-8089 | Fax: | ||||||||
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