Provider Demographics
NPI:1255198818
Name:PAUL, DAGMAR W (RN)
Entity type:Individual
Prefix:
First Name:DAGMAR
Middle Name:W
Last Name:PAUL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DAGMAR
Other - Middle Name:W
Other - Last Name:SHAHRIVAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:739 MORSE AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-3010
Mailing Address - Country:US
Mailing Address - Phone:669-267-4802
Mailing Address - Fax:
Practice Address - Street 1:739 MORSE AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-3010
Practice Address - Country:US
Practice Address - Phone:669-267-4802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA484093163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool