Provider Demographics
NPI:1629293964
Name:CARINI, DOROTHY A (LVN)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:A
Last Name:CARINI
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-3029
Mailing Address - Country:US
Mailing Address - Phone:530-872-3089
Mailing Address - Fax:
Practice Address - Street 1:352 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-3029
Practice Address - Country:US
Practice Address - Phone:530-872-3089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN127951164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEPS016160Medicaid
CARVN004320Medicaid