Provider Demographics
NPI:1982444741
Name:BANKS, LA RAE ROBIN (DRPH, MBA-HM)
Entity type:Individual
Prefix:DR
First Name:LA RAE
Middle Name:ROBIN
Last Name:BANKS
Suffix:
Gender:
Credentials:DRPH, MBA-HM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 MARIA LN STE 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5314
Mailing Address - Country:US
Mailing Address - Phone:925-433-8877
Mailing Address - Fax:925-553-4758
Practice Address - Street 1:1460 MARIA LN STE 300
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5314
Practice Address - Country:US
Practice Address - Phone:925-433-8877
Practice Address - Fax:925-533-4758
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program