Provider Demographics
NPI:1154293348
Name:PENCE, ROBIN BETH
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:BETH
Last Name:PENCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 LYNN DR
Mailing Address - Street 2:
Mailing Address - City:PENNGROVE
Mailing Address - State:CA
Mailing Address - Zip Code:94951-9553
Mailing Address - Country:US
Mailing Address - Phone:707-695-2236
Mailing Address - Fax:
Practice Address - Street 1:1320 LYNWOOD DR
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-4629
Practice Address - Country:US
Practice Address - Phone:707-695-2236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA845B1E0978171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach