Provider Demographics
NPI:1487831558
Name:KATHERINE W DORSCH
Entity Type:Organization
Organization Name:KATHERINE W DORSCH
Other - Org Name:DELANEY'S PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:W
Authorized Official - Last Name:DORSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-477-9596
Mailing Address - Street 1:3065 PORTER ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-2231
Mailing Address - Country:US
Mailing Address - Phone:831-477-9596
Mailing Address - Fax:888-441-1721
Practice Address - Street 1:3065 PORTER ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2231
Practice Address - Country:US
Practice Address - Phone:831-477-9596
Practice Address - Fax:888-441-1721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6165660001Medicare NSC