Provider Demographics
NPI:1639748171
Name:DORNBUSCH, HANNAH RUTH (WHNP-BC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:RUTH
Last Name:DORNBUSCH
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-1512
Mailing Address - Country:US
Mailing Address - Phone:608-658-5367
Mailing Address - Fax:
Practice Address - Street 1:2500 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-1397
Practice Address - Country:US
Practice Address - Phone:650-948-0807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-20
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018196363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health