Healthcare Provider Details

I. General information

NPI: 1417106030
Provider Name (Legal Business Name): ROBI-ANN DOYLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2008
Last Update Date: 09/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 YOSEMITE BLVD SUITE B
MODESTO CA
95354-2800
US

IV. Provider business mailing address

1625 RICHLAND AVE APT. 196
CERES CA
95307-4540
US

V. Phone/Fax

Practice location:
  • Phone: 209-341-1824
  • Fax: 209-523-1296
Mailing address:
  • Phone: 209-338-8429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: