Provider Demographics
NPI:1699219808
Name:KANGIESER, DONNA BATEN
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:BATEN
Last Name:KANGIESER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 TAMARISK CT
Mailing Address - Street 2:
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94505-9227
Mailing Address - Country:US
Mailing Address - Phone:925-858-8440
Mailing Address - Fax:
Practice Address - Street 1:2275 TAMARISK CT
Practice Address - Street 2:
Practice Address - City:DISCOVERY BAY
Practice Address - State:CA
Practice Address - Zip Code:94505-9227
Practice Address - Country:US
Practice Address - Phone:925-858-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program