Kathleen Roberge, MSN, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

NPP37711 Issued in RI

Practice address

3655 Nobel Dr
San Diego, CA 92122-1003

Phone

(888) 435-6500

NPI assigned

Apr 27, 2014

Last updated

Apr 27, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1398556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398556800000",
    "number": "1912327123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CHURCH ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724726",
            "telephone_number": "401-855-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 NOBEL DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221003",
            "telephone_number": "888-435-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERGE",
        "first_name": "KATHLEEN",
        "credential": "MSN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-27",
        "last_updated": "2014-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "RI",
            "license": "NPP37711",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2279104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shira L Robbins, M.D.
• Tara Kawn Robbins, M.D.
• Peregrine Nerisa Abling Robel, CCAPP R1403220820
• Echo Roben, LMFT
• Jason Lee Roberg, L.AC.
• Jessica Robershaw
• Floyd E Roberson, M.D.
• Latoya Michaele Roberson, FNP-BC
• Tessa Roberson
• Robert a McPherson Professional Chiropractic (Chiropractic sports and injury center)

• Gerontology Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.