Provider Demographics
NPI:1497555114
Name:CORBIN, ANNE KAY (CPM, LM)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:KAY
Last Name:CORBIN
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95240-3327
Mailing Address - Country:US
Mailing Address - Phone:208-819-8735
Mailing Address - Fax:
Practice Address - Street 1:135 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95240-3327
Practice Address - Country:US
Practice Address - Phone:208-819-8735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA762176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife