Provider Demographics
NPI:1952084105
Name:DOES, EMILY BRIANNE (PA STUDENT)
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:BRIANNE
Last Name:DOES
Suffix:
Gender:F
Credentials:PA STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4963 AVENIDA DE LAS ESTRELL
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3196
Mailing Address - Country:US
Mailing Address - Phone:657-594-0091
Mailing Address - Fax:
Practice Address - Street 1:4963 AVENIDA DE LAS ESTRELL
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-3196
Practice Address - Country:US
Practice Address - Phone:657-594-0091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program