Provider Demographics
NPI:1518179019
Name:HEMINGWAY, DOREEN RUFENER (LAC)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:RUFENER
Last Name:HEMINGWAY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:DODIE
Other - Middle Name:RUFENER
Other - Last Name:HEMINGWAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:2210 ENCINITAS BLVD.
Mailing Address - Street 2:SUITE E
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024
Mailing Address - Country:US
Mailing Address - Phone:760-632-7728
Mailing Address - Fax:760-632-7730
Practice Address - Street 1:2210 ENCINITAS BLVD.
Practice Address - Street 2:SUITE E
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024
Practice Address - Country:US
Practice Address - Phone:760-632-7728
Practice Address - Fax:760-632-7730
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6279171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist