Individual
KEVIN L DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
597 CENTER AVE, SUITE 200A, MARTINEZ, CA 94553-4640
(925) 676-6735
(925) 676-6465
Mailing address
597 CENTER AVE, SUITE 200A, MARTINEZ, CA 94553-4640
(925) 676-6735
(925) 676-6465
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
468098
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
468098
REGISTERED NUSE LICENSE
CA
Enumeration date
11/12/2014
Last updated
11/12/2014
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