Individual
MRS. CAROLE ADRIENNE DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2001 E ORANGETHORPE AVE STE D, PLACENTIA, CA 92870-6759
(714) 524-5545
Mailing address
2001 E ORANGETHORPE AVE STE D, PLACENTIA, CA 92870-6759
(714) 524-5545
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
216313
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33-0150193
MEDI-CAL
CA
Enumeration date
03/29/2010
Last updated
03/29/2010
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