Individual
DORCAS AMMERIS SOLIVAN JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
709 5TH AVE, SAN RAFAEL, CA 94901-3202
(415) 526-2486
Mailing address
709 5TH AVE, SAN RAFAEL, CA 94901-3202
(415) 526-2486
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-JEGRDM
CA
Other
Enumeration date
08/23/2023
Last updated
06/25/2024
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