Provider Demographics
NPI:1437201936
Name:MAZUREK, DOROTHY K (RN, CCM)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:K
Last Name:MAZUREK
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4409 E INYO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-2977
Mailing Address - Country:US
Mailing Address - Phone:559-453-4865
Mailing Address - Fax:
Practice Address - Street 1:4409 E INYO ST
Practice Address - Street 2:BLDG. 332
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-2977
Practice Address - Country:US
Practice Address - Phone:559-453-3806
Practice Address - Fax:559-453-6025
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435842163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health