Provider Demographics
NPI:1609025147
Name:DOERFLER, JEAN (CA NHA 5826)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:DOERFLER
Suffix:
Gender:F
Credentials:CA NHA 5826
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10471 PARISE DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-1159
Mailing Address - Country:US
Mailing Address - Phone:626-485-6772
Mailing Address - Fax:
Practice Address - Street 1:10471 PARISE DR
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-1159
Practice Address - Country:US
Practice Address - Phone:626-485-6772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA NHA 5826376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator