Individual
JENYA DVORKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2185 PACHECO ST, CONCORD, CA 94520-2309
(928) 676-0505
(925) 676-2814
Mailing address
2185 PACHECO ST, CONCORD, CA 94520-2309
(928) 676-0505
(925) 676-2814
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
16429
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DV0104322130
NCC
—
Enumeration date
09/12/2007
Last updated
09/12/2007
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