Provider Demographics
NPI:1629498480
Name:FERRISS, DORIANNE (RN)
Entity Type:Individual
Prefix:
First Name:DORIANNE
Middle Name:
Last Name:FERRISS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30795 SONORA ST
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-2721
Mailing Address - Country:US
Mailing Address - Phone:951-609-5105
Mailing Address - Fax:
Practice Address - Street 1:6235 RIVER CREST DR
Practice Address - Street 2:SUITE L
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-0788
Practice Address - Country:US
Practice Address - Phone:951-413-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA621415163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health