Provider Demographics
NPI:1023873403
Name:NAERBO, DORE ANN (PHD)
Entity type:Individual
Prefix:
First Name:DORE
Middle Name:ANN
Last Name:NAERBO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 BROKEN ARROW LN
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-4300
Mailing Address - Country:US
Mailing Address - Phone:214-272-0257
Mailing Address - Fax:
Practice Address - Street 1:SKOLTEN 31
Practice Address - Street 2:
Practice Address - City:SIREVAAG
Practice Address - State:HAA
Practice Address - Zip Code:43640
Practice Address - Country:NO
Practice Address - Phone:214-272-0257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARE2677146N00000X
NY171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic