Individual
DOREEN LATA KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4601 DALE RD, MODESTO, CA 95356-9718
(209) 735-3330
Mailing address
8755 HOLLOWSTONE WAY, SACRAMENTO, CA 95828-5588
(916) 212-0696
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95053217
CA
363LF0000X
Family Nurse Practitioner
Primary
95009130
CA
Other
Enumeration date
07/26/2018
Last updated
12/30/2021
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