Healthcare Provider Details

I. General information

NPI: 1811138712
Provider Name (Legal Business Name): SHANA RENEE DOOLIN F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1147 HARTNELL AVE
REDDING CA
96002-2113
US

IV. Provider business mailing address

1147 HARTNELL AVE
REDDING CA
96002-2113
US

V. Phone/Fax

Practice location:
  • Phone: 530-222-7213
  • Fax: 530-222-7268
Mailing address:
  • Phone: 530-222-7213
  • Fax: 530-222-7268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number16037
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP16037
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: