Provider Demographics
NPI:1164018891
Name:DOTSON, DANYELLE (PHLEBOTOMIST, CNA)
Entity Type:Individual
Prefix:
First Name:DANYELLE
Middle Name:
Last Name:DOTSON
Suffix:
Gender:F
Credentials:PHLEBOTOMIST, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13212 CASIMIR AVE
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90249-1633
Mailing Address - Country:US
Mailing Address - Phone:424-295-5939
Mailing Address - Fax:
Practice Address - Street 1:13212 CASIMIR AVE
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90249-1633
Practice Address - Country:US
Practice Address - Phone:424-295-5939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT00068411246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy