Provider Demographics
NPI:1225011224
Name:BALERIA, DOREEN CAROL (CRNA)
Entity Type:Individual
Prefix:MS
First Name:DOREEN
Middle Name:CAROL
Last Name:BALERIA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 DANVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-1738
Mailing Address - Country:US
Mailing Address - Phone:925-820-8557
Mailing Address - Fax:
Practice Address - Street 1:150 MUIR RD
Practice Address - Street 2:112A---ANESTHESIA
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4668
Practice Address - Country:US
Practice Address - Phone:925-372-2621
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAI307999174400000X
CA37905367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered174400000XOther Service ProvidersSpecialist
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered