Provider Demographics
NPI:1265958235
Name:THORBROGGER, DANESSA (NP-C)
Entity type:Individual
Prefix:MRS
First Name:DANESSA
Middle Name:
Last Name:THORBROGGER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MRS
Other - First Name:DANESSA
Other - Middle Name:
Other - Last Name:WESTFAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:565 KERN STREET
Mailing Address - Street 2:
Mailing Address - City:SHAFTER
Mailing Address - State:CA
Mailing Address - Zip Code:93263
Mailing Address - Country:US
Mailing Address - Phone:661-746-4937
Mailing Address - Fax:
Practice Address - Street 1:565 KERN STREET
Practice Address - Street 2:
Practice Address - City:SHAFTER
Practice Address - State:CA
Practice Address - Zip Code:93263
Practice Address - Country:US
Practice Address - Phone:661-746-4937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006735363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner