Provider Demographics
NPI:1093263931
Name:DENNETT, MARIE LORRAINE
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:LORRAINE
Last Name:DENNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:LORRAINE
Other - Last Name:REINDL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 LINCOLN AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-4900
Mailing Address - Country:US
Mailing Address - Phone:707-255-3718
Mailing Address - Fax:707-257-9727
Practice Address - Street 1:1100 LINCOLN AVE
Practice Address - Street 2:STE 202
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-4900
Practice Address - Country:US
Practice Address - Phone:707-255-3718
Practice Address - Fax:707-257-9727
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator