Provider Demographics
NPI:1295130748
Name:PARKER, DOROTA
Entity type:Individual
Prefix:
First Name:DOROTA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DOROTA
Other - Middle Name:
Other - Last Name:KORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10925 OAKHAM DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6262
Mailing Address - Country:US
Mailing Address - Phone:916-204-2716
Mailing Address - Fax:
Practice Address - Street 1:10925 OAKHAM DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-6262
Practice Address - Country:US
Practice Address - Phone:916-204-2716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114989106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist