Laura Robin Colebourn

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95016422 Issued in CA

Practice address

500 Union Ave
Fairfield, CA 94533-6317

Phone

(415) 994-5309

NPI assigned

Nov 8, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Laura Robin O'Brien Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Contra Costa County

  dba West County Adult Mental Health Services

  • Adult Mental Health Clinic/Center
  • San Pablo, CA
  • NPI 1376620336
  Medicare reassignment NPD
• Lifelong Medical Care

  dba Over Sixty Health Center

  • Geriatric Medicine (Family Medicine) Physician
  • Berkeley, CA
  • NPI 1689670002
  Medicare reassignment NPD
• Contra Costa County

  dba East County Adult Mental Health Services

  • Adult Mental Health Clinic/Center
  • Pittsburg, CA
  • NPI 1073691598
  NPD
• Contra Costa County

  dba Contra Costa Health

  • General Acute Care Hospital
  • Martinez, CA
  • NPI 1386719086
  NPD
• Lifelong Medical Care

  • Family Medicine Physician
  • Rodeo, CA
  • NPI 1003289463
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1679118186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2344 6TH ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947102412",
            "telephone_number": "510-981-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNION AVE",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336317",
            "telephone_number": "415-994-5309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1399 Carriage Dr",
            "address_purpose": "LOCATION",
            "city": "Walnut Creek",
            "state": "CA",
            "postal_code": "945981253",
            "country_code": "US",
            "telephone_number": "415-994-5309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEBOURN",
        "first_name": "LAURA",
        "middle_name": "ROBIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-08",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "644782",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95016422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "O'BRIEN",
            "middle_name": "ROBIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Debra Coffey-Rush
• Terri Chardonay Cofield
• Gary Coghlan
• Chanel Mahealani Cole
• Curtis Cole
• Colanda Coleman
• Dominique Coleman
• Kristina Jacqueline Coleman
• Kianna Vhanrich Lin Colina
• Kiasi Collier

• Family Nurse Practitioner in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.