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Individual

DR. DORANN LEE BOULIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
2100 PEABODY ROAD, VACAVILLE, CA 95695-4000
(707) 451-0182
(707) 451-3462
Mailing address
PO BOX 4000, VACAVILLE, CA 95696-4000

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 9705
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSY 9705
LICENSED PSYCHOLOGIST
CA
Enumeration date
07/05/2013
Last updated
07/05/2013
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