Provider Demographics
NPI:1427225515
Name:MYERS, DOREEN LEA (ACNP)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:LEA
Last Name:MYERS
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 CAMINO AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-7606
Mailing Address - Country:US
Mailing Address - Phone:714-245-0018
Mailing Address - Fax:714-245-0019
Practice Address - Street 1:1818 CAMINO AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-7606
Practice Address - Country:US
Practice Address - Phone:714-245-0018
Practice Address - Fax:714-245-0019
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA326794363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care