Healthcare Provider Details

I. General information

NPI: 1902721236
Provider Name (Legal Business Name): ROSEMARIE JANE DOLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4733 E OLD WEST RD
KINGMAN AZ
86401-5281
US

IV. Provider business mailing address

1200 CONCORD AVE STE 185
CONCORD CA
94520-5006
US

V. Phone/Fax

Practice location:
  • Phone: 425-583-0465
  • Fax:
Mailing address:
  • Phone: 510-268-8120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: