Healthcare Provider Details

I. General information

NPI: 1982901328
Provider Name (Legal Business Name): ADRIANE MARIE DORAME LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2011
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 GREAT AMERICA PKWY STE 320
SANTA CLARA CA
95054-1140
US

IV. Provider business mailing address

PO BOX 8383
REDLANDS CA
92375-1583
US

V. Phone/Fax

Practice location:
  • Phone: 323-745-8323
  • Fax:
Mailing address:
  • Phone: 840-251-1848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number28135
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number71099
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: