Provider Demographics
NPI:1598947335
Name:DORNFELD, LYNN HELEN (MSN/RNP/CNM)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:HELEN
Last Name:DORNFELD
Suffix:
Gender:F
Credentials:MSN/RNP/CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13153 PASEO DEL VERANO
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-1837
Mailing Address - Country:US
Mailing Address - Phone:619-889-4612
Mailing Address - Fax:
Practice Address - Street 1:13153 PASEO DEL VERANO
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-1837
Practice Address - Country:US
Practice Address - Phone:619-889-4612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11826363LX0001X
CA1455367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ43199Medicare UPIN