Provider Demographics
NPI:1801270863
Name:DOERR-KASHANI, PAMELA (NP)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:DOERR-KASHANI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:DOERR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP, RN, PHN
Mailing Address - Street 1:6090 REDWOOD BLVD G
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-4569
Mailing Address - Country:US
Mailing Address - Phone:415-798-3106
Mailing Address - Fax:415-798-3180
Practice Address - Street 1:9 UNIONSTONE LN
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-1315
Practice Address - Country:US
Practice Address - Phone:415-271-8320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95002634363LF0000X
CA498751163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse