Provider Demographics
NPI:1255018644
Name:DEVEGA, ROBIN AMBAT (RNFA)
Entity type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:AMBAT
Last Name:DEVEGA
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8008 FROST ST STE 311
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4288
Mailing Address - Country:US
Mailing Address - Phone:858-292-5175
Mailing Address - Fax:
Practice Address - Street 1:8008 FROST ST STE 311
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4288
Practice Address - Country:US
Practice Address - Phone:858-292-5175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA605896163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant