Provider Demographics
NPI:1598823353
Name:ROBBINS, PANDORA NADEAN (LVN)
Entity type:Individual
Prefix:MRS
First Name:PANDORA
Middle Name:NADEAN
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13163 TERRY CT
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-4231
Mailing Address - Country:US
Mailing Address - Phone:951-488-9716
Mailing Address - Fax:951-922-6955
Practice Address - Street 1:14700 MANZANITA PARK ROAD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-0247
Practice Address - Country:US
Practice Address - Phone:951-845-3155
Practice Address - Fax:951-922-6955
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN191849164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse