Individual
JANNA LYN DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1779 DOMINICAN WAY, SUITE B, SANTA CRUZ, CA 95065-1526
(831) 479-4966
(831) 479-4967
Mailing address
1779 DOMINICAN WAY, SUITE B, SANTA CRUZ, CA 95065-1526
(831) 479-4966
(831) 479-4967
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A64380
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0098130
—
CA
Enumeration date
08/15/2006
Last updated
12/13/2021
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